Independent Physical Therapy of Ga, LLC

NPI #1962976563 in Senoia, Georgia

Provider Information

NPI Number: 1962976563
Entity Type: Organization
Organization Name: Independent Physical Therapy of Ga, LLC
Primary Specialty: Physical Therapist
Enumeration Date: Jan 16, 2019
Last Updated: Jan 16, 2019

Practice Location

Address: 10 VILLAGE WEST DR. STE A
City: Senoia
State: Georgia
ZIP Code: 30276
Phone: (123) 999-8765

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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