Organization
BENCHMARK PHYSICAL THERAPY OF NC, LLC
Active
Other names
Benchmark PT - Southport
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-7217
Entity
Organization
Contact information
Practice address
2819 MIDWAY RD SE STE 114, BOLIVIA, NC 28422-8003
(910) 253-6930
(910) 253-6934
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
06/18/2017
Last updated
06/18/2017
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