Independent Physical Therapy LLC

NPI #1710154406 in East Ridge, Tennessee

Provider Information

NPI Number: 1710154406
Entity Type: Organization
Organization Name: Independent Physical Therapy LLC
Primary Specialty: Physical Therapist
Enumeration Date: May 12, 2008
Last Updated: Nov 14, 2019

Practice Location

Address: 1467 N MACK SMITH RD
City: East Ridge
State: Tennessee
ZIP Code: 37412-3947
Phone: (423) 894-4403

Authorized Official

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

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Speech-Language Pathologist	235Z00000X
Physical Therapist	225100000X	Primary

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