Lynley    Corley    OTR
Contract Details
BenchMark Physical Therapy
Facility name
Provider ID
P000000001
NPI
1487238838
Tax ID
300714977
Effective Date
5/24/2021
Last Updated
5/19/2021
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
8823 Production Lane
Ooltewah, TN 37363
Billing Phone
423-238-7217
Specialty Type
Occupational Therapy
Map
Address