Healthcare Provider Details
I. General information
NPI: 1346863305
Provider Name (Legal Business Name): BENCHMARK PHYSICAL THERAPY OF OR, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/26/2020
Last Update Date: 05/26/2020
Certification Date: 05/26/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4325 COMMERCE ST STE 114
EUGENE OR
97402-5467
US
IV. Provider business mailing address
1200 CORPORATE DR STE 400
BIRMINGHAM AL
35242-5424
US
V. Phone/Fax
- Phone: 541-505-8054
- Fax: 541-844-1064
- Phone: 423-238-8923
- Fax: 423-954-7399
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:
BRYAN
BARGANIER
Title or Position: CFO
Credential:
Phone: 205-536-7602