MEDICARE: BENCHMARK PHYSICAL THERAPY OF NC, 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
1	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1023744257
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENCHMARK PHYSICAL THERAPY OF NC, LLC

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-238-7217
Fax Number	:	423-238-3473

Provider Business Practice Location Address
First Line	:	13500 NC HIGHWAY 50 STE 103
Second Line	:
City	:	SURF CITY
State	:	NC
Zip	:	28445-7935
Country	:	US
Telephone Number	:	910-507-1009
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	THOMAS BRYAN BARGANIER
Credential	:
Telephone Number	:	205-536-7602

Provider Enumeration Date	:	07/29/2022
Last Update Date	:	07/29/2022

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