Organization
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Active
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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