Healthcare Provider Details
I. General information
NPI: 1669094942
Provider Name (Legal Business Name): BENCHMARK PHYSICAL THERAPY OF DELAWARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/10/2020
Last Update Date: 05/13/2024
Certification Date: 05/13/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 GEORGETOWN PLZ
GEORGETOWN DE
19947-2300
US
IV. Provider business mailing address
1200 CORPORATE DR STE 400
BIRMINGHAM AL
35242-5424
US
V. Phone/Fax
- Phone: 302-858-4528
- Fax: 302-858-4594
- Phone: 423-238-8923
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PREET
TAKKAR
Title or Position: COO
Credential:
Phone: 408-914-8737