Organization
INDEPENDENT PHYSICAL THERAPY
Active
Other names
BenchMark Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
TROY BAGE (PRESIDENT)
(423) 238-7217
Entity
Organization
Contact information
Practice address
1202 N CHARLES G SEIVERS BLVD STE A, CLINTON, TN 37716-3936
(865) 457-0192
(865) 457-2284
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03650060
—
TN
01
—
3156797
BCBST GROUP #
TN
Enumeration date
05/13/2008
Last updated
06/24/2010
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