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Contract Details
BenchMark Physical Therapy of Alabama, LLC
Facility name
BeachMark Physical Therapy
Provider ID
P000009247
Tax ID
300714977
Effective Date
10/22/2018
Last Updated
11/2/2018
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
County
Jefferson
Phone
2055736278
(
Phone
)
Billing Details
Address
6397 Lee Hwy
Suite 300
Chattanooga, TN 37421
Billing Phone
8005781104
Specialty Type
Physical Therapy
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Address