Independent Physical Therapy of Ga, LLC

NPI #1942697362 in Brookhaven, Georgia

Provider Information

NPI Number: 1942697362
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Apr 23, 2015
Last Updated: Apr 23, 2015

Practice Location

Address: 705 TOWN BLVD NE STE 550
City: Brookhaven
State: Georgia
ZIP Code: 30319-7216
Phone: (404) 869-1912

Authorized Official

Name: KEVIN JOHANNESON
Title: VP REVENUE CYCLE
Phone: (423) 238-8923

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X
Physical Therapist	225100000X	Primary

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