Organization
INDEPENDENT PHYSICAL THERAPY
Active
Other names
BENCHMARK PHYSICAL THERAPY
Organization subpart
No
Provider details
NPI number
Authorized official
LISA BENETTO (CREDENTIALING MANAGER)
(423) 238-8923
Entity
Organization
Contact information
Practice address
2946 WINFIELD DUNN PKWY STE 106, KODAK, TN 37764-4318
(865) 932-1088
(865) 932-1454
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 954-7399
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
08/26/2014
Last updated
08/26/2014
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