Independent Physical Therapy of Georgia, LLC

NPI #1457608861 in Canton, Georgia

Provider Information

NPI Number: 1457608861
Entity Type: Organization
Organization Name: Independent Physical Therapy of Georgia, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Aug 6, 2012
Last Updated: May 10, 2017

Practice Location

Address: 1453 RIVERSTONE PKWY
Address 2: STE 170
City: Canton
State: Georgia
ZIP Code: 30114-5626
Phone: (770) 704-0774

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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