Healthcare Provider Details

I. General information

NPI: 1285099051
Provider Name (Legal Business Name): BENCHMARK PHYSICAL THERAPY OF ALABAMA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2015
Last Update Date: 01/27/2022
Certification Date: 01/27/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4500 MONTEVALLO RD STE E107
IRONDALE AL
35210-3128
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 205-957-0870
  • Fax: 205-957-0872
Mailing address:
  • Phone: 232-387-2174
  • Fax: 423-238-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateAL

VIII. Authorized Official

Name: BRYAN BARGANIER
Title or Position: CFO
Credential:
Phone: 205-536-7602