Brianna    Jackson    RPT
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000009445
NPI
1366000200
Tax ID
300714977
Effective Date
11/11/2019
Last Updated
11/8/2019
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
7721 Airport Blvd Suite E120
Mobile, AL 36608
United States
County
Mobile
Phone
2516313680 (Phone)
Billing Details
Address
8823 Production Lane
Ooltewah, TN 37363
Billing Phone
4232387217
Specialty Type
Physical Therapy
Map
Address