Independent Physical Therapy of Ga, LLC

NPI #1376079772 in Port Wentworth, Georgia

Provider Information

NPI Number: 1376079772
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga, LLC
Primary Specialty: Physical Therapist
Enumeration Date: May 4, 2017
Last Updated: May 4, 2017

Practice Location

Address: 7938 GA HIGHWAY 21
Address 2: STE 300
City: Port Wentworth
State: Georgia
ZIP Code: 31407-9807
Phone: (912) 965-0601

Authorized Official

Name: KEVIN JOHANNESON
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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