Chiropractic Provider Request
 


If you wish to participate with DPSC as a Chiropractor provider for the DPSC Network. Please fax to us at 386-672-4811, on your letterhead, a request to participate, or fill in the form below and we will send you an application and contract packet.

DPSC does not charge an application fee or credential fee for Chiropractors.

 

Name

Street

City State Zip

Phone Fax

Specialty   ID#

Email  


Copyright 2003    DPSC Inc.   All Rights Reserved    Doctors Professional Services Consultants Chiropractic Network
Contact us at: D.P.S.C. Inc.  50 S. Perrott Drive  Ormond Beach, Florida 32174
Phone 386-615-0801   Fax 386-672-4811   e-mail: service@dpsc.info
 WebSite Design by TRMFL