MEDICARE: BENCHMARK PHYSICAL THERAPY INDIANA 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	:	1588247670
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BENCHMARK PHYSICAL THERAPY INDIANA 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	:

Provider Business Practice Location Address
First Line	:	9105 E 56TH ST STE I
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46216-2231
Country	:	US
Telephone Number	:	463-207-9995
Fax Number	:	463-237-5351

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

Provider Enumeration Date	:	05/05/2021
Last Update Date	:	05/05/2021

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Directions to “BENCHMARK PHYSICAL THERAPY INDIANA LLC ” Practice Location

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