Independent Physical Therapy of Georgia, LLC

NPI #1518418409 in Rome, Georgia

Provider Information

NPI Number: 1518418409
Entity Type: Organization
Organization Name: Independent Physical Therapy of Georgia, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Oct 17, 2016
Last Updated: Nov 14, 2018

Practice Location

Address: 330 TURNER MCCALL BLVD SW STE 2000
City: Rome
State: Georgia
ZIP Code: 30165-5618
Phone: (706) 235-6555

Authorized Official

Name: KEVIN JOHANNESON
Title: VP PROVIDER ENROLLMENT
Phone: (423) 238-8923

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Specialist/Technologist	235500000X
Physical Therapist	225100000X	Primary

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