Erin    Sims    RPT
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000009185
NPI
1952839904
Tax ID
300714977
Effective Date
6/1/2018
Last Updated
5/17/2019
Direct Contract
Yes
Term Date
12/31/2018
Status
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
12110 County Line Road Suite B
Madison, AL 35756
United States
County
Limestone
Phone
2562329001 (Phone)
Billing Details
Address
6397 Lee Hwy
Suite 300
Chattanooga, TN 37421
Billing Phone
6158593852
Specialty Type
Physical Therapy
Map
Address