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Contract Details
Facility name
BenchMark Physical Therapy
Provider ID
P000000001
NPI
1659642916
Tax ID
300714977
Effective Date
9/13/2021
Last Updated
8/27/2021
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
2822 Lakeshore Parkway
Birmingham, AL 35211
United States
Phone
205-848-6841
(
Phone
)
Fax
205-847-5235
Billing Details
Address
6397 Lee Highway
Suite 300
Chattanooga, TN 37421
Billing Phone
423-933-2346
Specialty Type
Physical Therapy
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