Independent Physical Therapy of Ga, LLC

NPI #1174927784 in Canton, Georgia

Provider Information

NPI Number: 1174927784
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Oct 11, 2014
Last Updated: Oct 11, 2014

Practice Location

Address: 6768 HICKORY FLAT HWY
Address 2: STE 110
City: Canton
State: Georgia
ZIP Code: 30115-9376
Phone: (770) 721-5767

Authorized Official

Name: KEVIN JOHANNESON
Title: VP REVENUE CYCLE
Phone: (423) 238-7217

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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