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Organization

INDEPENDENT PHYSICAL THERAPY, LLC

Active
Other names
BenchMark
Organization subpart
No

Provider details

NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCEL)
(423) 238-8923
Entity
Organization

Contact information

Practice address
203 VILLAGE SQ, PULASKI, TN 38478-2929
(931) 424-5588
(931) 424-5590
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-8923

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Enumeration date
08/11/2015
Last updated
08/11/2015
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