Organization
INDEPENDENT PHYSICAL THERAPY OF GA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (CFO)
(423) 238-2313
Entity
Organization
Contact information
Practice address
6035 PEACHTREE RD STE C206, DORAVILLE, GA 30360-3239
(423) 238-7217
(423) 238-3473
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
08/28/2020
Last updated
08/28/2020
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