Independent Physical Therapy of Georgia, LLC

NPI #1013292119 in Marietta, Georgia

Provider Information

NPI Number: 1013292119
Entity Type: Organization
Organization Name: Independent Physical Therapy of Georgia, LLC
Primary Specialty: Clinic/Center - Physical Therapy
Enumeration Date: Oct 20, 2011
Last Updated: Nov 1, 2011

Practice Location

Address: 1205 JOHNSON FERRY RD STE 130
City: Marietta
State: Georgia
ZIP Code: 30068-5418
Phone: (770) 565-3201

Authorized Official

Name: TROY DALE BAGE
Title: PRESIDENT
Phone: (423) 238-7217

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Clinic/Center - Rehabilitation — Rehabilitation	261QR0400X
Clinic/Center - Physical Therapy — Physical Therapy	261QP2000X	Primary

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