Organization
INDEPENDENT PHYSICAL THERAPY
Active
Other names
BenchMark
Organization subpart
No
Provider details
NPI number
Authorized official
MARVETTE WALLACE (DIRECTOR- CONTRACT MANAGEMENT)
(423) 238-7217
Entity
Organization
Contact information
Practice address
323 SAM RIDLEY PKWY W, SMYRNA, TN 37167-5625
(615) 751-5211
(615) 751-8049
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
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
01/07/2013
Last updated
01/07/2013
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