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Chandler
Ancona
Contract Details
BenchMark Physical Therapy of Alabama
Facility name
Provider ID
P000000001
Tax ID
300714977
Effective Date
2/7/2020
Last Updated
4/2/2020
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
1045 Broadway Park Suite 107
Homewood, AL 35209
United States
Phone
205-573-6278
(
Phone
)
Fax
205-573-6280
Billing Details
Address
6397 Lee Hwy
Suite 300
Chattanooga, TN 37421
Billing Phone
423-238-7217
Specialty Type
Physical Therapy
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