Kayla    Glenzer    RPT
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000008690
NPI
1396279329
Tax ID
300714977
Effective Date
6/12/2017
Last Updated
4/27/2017
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
151 Fly Creek Ave Ste 438
Fairhope, AL 36532
United States
County
Baldwin
Phone
3342980650 (Phone)
Billing Details
Address
8823 Production Lane
Ooltewah, TN 37363
Billing Phone
4232381817
Specialty Type
Physical Therapy
Map
Address