Healthcare Provider Details

I. General information

NPI: 1003781469
Provider Name (Legal Business Name): BENCHMARK PHYSICAL THERAPY OF MISSISSIPPI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W RAILROAD ST STE 105
LONG BEACH MS
39560-4517
US

IV. Provider business mailing address

1200 CORPORATE DR STE 400
HOOVER AL
35242-5424
US

V. Phone/Fax

Practice location:
  • Phone: 228-273-1012
  • Fax: 228-273-1015
Mailing address:
  • Phone: 423-238-7210
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: LAUREN HILL
Title or Position: DIRECTOR OF CREDENTIALING
Credential:
Phone: 972-465-0296