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Andrew
Patterson
RPT
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000009332
NPI
1710396759
Tax ID
300714977
Effective Date
3/11/2019
Last Updated
3/21/2019
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2846 Moody Parkway Suite 200
Moody, AL 35004
United States
County
Saint Clair
Phone
2056404881
(
Phone
)
Billing Details
Address
8823 Production Lane
Ooltewah, TN 37363
Billing Phone
4232387217
Specialty Type
Physical Therapy
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Address