Organization
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Active
Other names
Benchmark PT
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP PROVIDER ENROLLMENT)
(423) 238-8923
Entity
Organization
Contact information
Practice address
330 TURNER MCCALL BLVD SW STE 2000, ROME, GA 30165-5618
(706) 235-6555
(706) 378-3150
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
—
—
235500000X
Speech/Language/Hearing Specialist/Technologist
—
—
Other
Enumeration date
10/17/2016
Last updated
11/14/2018
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