Independent Physical Therapy of Ga, LLC

NPI #1689048746 in Dacula, Georgia

Provider Information

NPI Number: 1689048746
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Nov 30, 2015
Last Updated: Nov 30, 2015

Practice Location

Address: 2515 FENCE RD STE 160
City: Dacula
State: Georgia
ZIP Code: 30019-2138
Phone: (770) 237-2852

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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