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Contract Details
Benchmark Physical Therapy
Facility name
Independent Physical Therapy
Provider ID
P000000001
NPI
1780636068
Tax ID
270039366
Effective Date
8/1/2022
Last Updated
8/1/2022
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
85.00
Location Details
Address
810 Plaza Drive
Zebulon, GA 30295
United States
Phone
678-451-1280
(
Phone
)
Fax
678-981-6715
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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