Independent Physical Therapy of Ga LLC

NPI #1134787278 in College Park, Georgia

Provider Information

NPI Number: 1134787278
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jun 4, 2019
Last Updated: Jun 4, 2019

Practice Location

Address: 6395 OLD NATIONAL HWY STE 300A
City: College Park
State: Georgia
ZIP Code: 30349-4475
Phone: (404) 333-3333

Authorized Official

Name: KEVIN JOHANNESON
Title: VP REVENUE CYCLE
Phone: (423) 238-2313

Specialties & Taxonomy Codes

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

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