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Contract Details
BenchMark Physical Therapy
Facility name
Independent Physical Therapy
Provider ID
P000000001
NPI
1780636068
Tax ID
270039366
Effective Date
10/4/2021
Last Updated
10/6/2021
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
4319 Hartley Bridge Road Suite 150
Macon, GA 31216
United States
Phone
478-333-5111
(
Phone
)
Fax
478-845-2970
Billing Details
Address
6397 Lee Hwy
Suite 300
Chattanooga, TN 37421
Billing Phone
423-238-7217
Specialty Type
Physical Therapy
Workers Comp Coordinator
Lauren
Larkey
800-578-1104
workcomp@urpt.com
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