Kristyn    Thacker Wing    RPT
Contract Details
BenchMark Physical Therpay
Facility name
Provider ID
P000009198
NPI
1518454321
Tax ID
300714977
Effective Date
12/17/2018
Last Updated
5/17/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
100 N Florida Street Suite 31
Mobile, AL 36607
United States
County
Mobile
Phone
2513008874 (Phone)
Billing Details
Address
6397 Lee Highway
Suite 300
Chattanooga, TN 37421
Billing Phone
2513008874
Specialty Type
Physical Therapy
Map
Address