Organization
INDEPENDENT PHYSICAL THERAPY OF GA, LLC
Active
Other names
BENCHMARK PT
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-8923
Entity
Organization
Contact information
Practice address
78 DAWSON VILLAGE WAY N STE 230, DAWSONVILLE, GA 30534-5642
(678) 865-8449
(678) 865-8451
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
235Z00000X
Speech-Language Pathologist
—
—
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
05/14/2008
Last updated
08/31/2015
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