Independent Physical Therapy of Georgia, LLC

NPI #1114384500 in Jasper, Georgia

Provider Information

NPI Number: 1114384500
Entity Type: Organization
Organization Name: Independent Physical Therapy of Georgia, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jan 15, 2016
Last Updated: Jan 15, 2016

Practice Location

Address: 744 NOAH DR STE 107
City: Jasper
State: Georgia
ZIP Code: 30143-8704
Phone: (706) 253-3131

Authorized Official

Name: KEVIN JOHANNESON
Title: VP REVENUE CYCLE
Phone: (423) 238-8923

Specialties & Taxonomy Codes

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

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