Catherine    Brock    OTR
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000000001
NPI
1841447463
Tax ID
300714977
Effective Date
10/12/2020
Last Updated
10/6/2020
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
151 Fly Creek Avenue Suite 438
Fairhope, AL 36532
United States
Phone
251-928-9619 (Phone)
Billing Details
Address
151 Fly Creek Avenue
Suite 438
Ooltewah, TN 36532
Billing Phone
423-238-7217
Specialty Type
Occupational Therapy
Map
Address