Michael    Ferguson    RPT
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000009321
NPI
1497227961
Tax ID
300714977
Effective Date
2/20/2019
Last Updated
2/22/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
4500 Montevallo Road Suite B-108
Birmingham, AL 35210
United States
County
Jefferson
Phone
2059570870 (Phone)
Billing Details
Address
8823 Production Lane
Ooltewah, TN 37363
Billing Phone
4232387217
Specialty Type
Physical Therapy
Map
Address