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NPI Code Detail

MEDICARE: BENCHMARK PHYSICAL THERAPY OF VA, LLC

MEDICARE: BENCHMARK PHYSICAL THERAPY OF VA, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1871063925
Entity Type Code : Organization
Provider Name (Legal Business Name) : BENCHMARK PHYSICAL THERAPY OF VA, LLC
Provider Business Mailing Address
First Line : 6397 LEE HWY STE 300
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-4915
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1609 N COALTER ST
Second Line :
City : STAUNTON
State : VA
Zip : 24401-2552
Country : US
Telephone Number : 540-213-1320
Fax Number :
Authorized Official
Title or Position : VP REVENUE CYCLE
Name : KEVIN JOHANNESON
Credential :
Telephone Number : 423-238-2313
Provider Enumeration Date : 12/03/2018
Last Update Date : 12/03/2018

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Directions to “BENCHMARK PHYSICAL THERAPY OF VA, LLC ” Practice Location

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