Organization
INDEPENDENT PHYSICAL THERAPY OF GA, LLC
Active
Other names
Benchmark PT - Roswell Mill
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-3220
Entity
Organization
Contact information
Practice address
9420 WILLEO RD, STE 202, ROSWELL, GA 30075-6772
(770) 594-7250
(770) 594-7251
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
03/21/2017
Last updated
03/21/2017
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