Dara    Irving    RPT
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000009326
NPI
1255730792
Tax ID
300714977
Effective Date
3/1/2019
Last Updated
3/5/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1045 Broadway Park Suite 107
Homewood, AL 35209
United States
County
Jefferson
Phone
2055736278 (Phone)
Billing Details
Address
6397 Lee Highway
Suite 300
Chattanooga, TN 37421
Billing Phone
8005781104
Specialty Type
Physical Therapy
Map
Address