Organization
INDEPENDENT PHYSICAL THERAPY OF GA, LLC
Active
Other names
BenchMark PT - Peachtree Starrs Mill
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP OF REVENUE CYCLE)
(423) 238-7217
Entity
Organization
Contact information
Practice address
1280 HIGHWAY 74 S, STE 210, PEACHTREE CITY, GA 30269-3077
(770) 486-6398
(770) 486-6399
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
03/06/2017
Last updated
03/06/2017
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