Independent Physical Therapy of Ga, LLC

NPI #1083162978 in Pooler, Georgia

Provider Information

NPI Number: 1083162978
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Sep 20, 2016
Last Updated: Sep 20, 2016

Practice Location

Address: 119 CANAL ST
Address 2: STE 104
City: Pooler
State: Georgia
ZIP Code: 31322-4095
Phone: (912) 330-8444

Authorized Official

Name: KEVIN JOHANNESON
Title: VP OF REVENUE
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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