Kristyn    Thacker Wing    RPT
Contract Details
BenchMark Physical Therapy of Alabama, LLC
Facility name
Provider ID
P000009198
NPI
1518454321
Tax ID
300714977
Effective Date
8/3/2018
Last Updated
5/17/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
151 Fly Creek Avenue Suite 438
Fairhope, AL 36532
United States
County
Baldwin
Phone
2519289619 (Phone)
Billing Details
Address
8823 Production Lane
Ooltewah, TN 37363
Billing Phone
4232387217
Specialty Type
Physical Therapy
Map
Address