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Olivia
Walker
RPT
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000000001
NPI
1013523810
Tax ID
300714977
Effective Date
12/1/2020
Last Updated
12/17/2020
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
75.00
Location Details
Address
2846 Moody Parkway
Moody, AL 35004
United States
Phone
205-640-4881
(
Phone
)
Billing Details
Address
8823 Production Lane
Ooltewah, TN 37363
Billing Phone
423-238-7217
Specialty Type
Physical Therapy
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