Independent Physical Therapy of Ga, LLC

NPI #1043672678 in Marietta, Georgia

Provider Information

NPI Number: 1043672678
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Mar 23, 2016
Last Updated: Mar 23, 2016

Practice Location

Address: 3855 SHALLOWFORD RD
Address 2: 415
City: Marietta
State: Georgia
ZIP Code: 30062-4195
Phone: (678) 352-0828

Authorized Official

Name: KEVIN JOHANESON
Title: VP REVENUE CYCLE
Phone: (423) 238-3220

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Physical Therapist	225100000X	Primary

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