Organization
INDEPENDENT PHYSICAL THERAPY
Active
Other names
BenchMark Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-2313
Entity
Organization
Contact information
Practice address
7693 RHEA COUNTY HWY STE 2, DAYTON, TN 37321-6083
(423) 570-0907
(423) 570-0936
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-4915
(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
—
0446652
—
TN
01
—
3156797
BCBST GROUP #
TN
Enumeration date
05/09/2008
Last updated
02/05/2019
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