Provider AgreementProvider Agreement • January 17th, 2013
Contract Type FiledJanuary 17th, 2013THIS Provider Agreement (“Agreement”), effective this day of , 20 , by and between Avesis Third Party Administrators, Inc. (“Avesis”) and , (hereinafter referred to as Provider);
Provider AgreementProvider Agreement • October 7th, 2011
Contract Type FiledOctober 7th, 2011THIS Provider Agreement (“Agreement”), effective this _ day of , 20_ , by and between Avesis Third Party Administrators, Inc. (“Avesis”) and , (hereinafter referred to as Provider);