Contract Details
BenchMark Physical Therapy
Facility name
BenchMark Physical Therapy
Provider ID
P000008902
NPI
1104878354
Tax ID
621754125
Effective Date
6/27/2017
Last Updated
4/12/2018
Direct Contract
Yes
Status
Active
Contract Discounts
Discount Type
M
State Fee Schedule Multiplier
0.00
Exhibit ID
AM_459
Location Details
Address
2913 Boones Creek Rd Suite 1
Johnson City, TN 37615
United States
County
Washington
Phone
4232320688 (Phone)
Billing Details
Address
6397 Lee Hwy
Suite 300
Chattanooga, TN 37421
Billing Phone
4232320688
Specialty Type
Physical Therapy
Map
Address