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Contract Details
BenchMark Physical Therapy
Facility name
Independent Physical Therapy
Provider ID
P000000001
NPI
1104878354
Tax ID
621754125
Effective Date
3/14/2022
Last Updated
2/23/2022
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_459
Exhibit Attachment
Location Details
Address
4356 Maynardville Hwy Suite 3
Maynardville, TN 37807
United States
Phone
423-238-3215
(
Phone
)
Fax
423-238-3473
Billing Details
Address
6397 Lee Hwy
Suite 300
Chattanooga, TN 37421
Billing Phone
423-238-7217
Specialty Type
Physical Therapy
Website
Visit Website
Workers Comp Coordinator
Lauren
Lakey
800-578-1104
workcomp@urpt.com
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