MEDICARE: BENCHMARK PHYSICAL THERAPY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	261QM1300X	Multi-Specialty Clinic/Center
2	261QR0400X	Rehabilitation Clinic/Center
3	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1669703674
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENCHMARK PHYSICAL THERAPY, INC

Provider Business Mailing Address
First Line	:	6397 LEE HWY STE 300
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37421-2564
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:	423-238-3473

Provider Business Practice Location Address
First Line	:	1275 HIGHWAY 54 W STE 200
Second Line	:
City	:	FAYETTEVILLE
State	:	GA
Zip	:	30214-4538
Country	:	US
Telephone Number	:	770-460-8609
Fax Number	:	770-460-8629

Authorized Official
Title or Position	:	PRESIDENT
Name	:	TROY BAGE
Credential	:
Telephone Number	:	423-238-7217

Provider Enumeration Date	:	01/15/2010
Last Update Date	:	09/06/2017

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