Contract Details
BenchMark Physical Therapy
Facility name
BenchMark Physical Therapy Dacula 316
Provider ID
P000008801
NPI
1689048746
Tax ID
270039366
Effective Date
6/19/2017
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2515 Fence Rd Suite 160
Dacula, GA 30019
United States
County
Gwinnett
Phone
7702372852 (Phone)
Billing Details
Address
6397 Lee Hwy
Suite 300
Chattanooga, TN 37421
Billing Phone
7702372852
Specialty Type
Physical Therapy
Map
Address