Independent Physical Therapy of Ga LLC

NPI #1912499054 in Mableton, Georgia

Provider Information

NPI Number: 1912499054
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jun 5, 2018
Last Updated: Jun 5, 2018

Practice Location

Address: 1025 VETERANS MEMORIAL HWY SE STE 640
City: Mableton
State: Georgia
ZIP Code: 30126-7711
Phone: (833) 881-9256

Authorized Official

Name: KEVIN JOHANNESON
Title: VP REVENUE CYCLE
Phone: (423) 238-2313

Specialties & Taxonomy Codes

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

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