Organization
PHYSICAL THERAPY PROS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD J MCKIBBEN (OWNER)
(706) 325-6971
Entity
Organization
Contact information
Practice address
140 JOHNNY MERCER BLVD STE 10A, SAVANNAH, GA 31410-2169
(404) 590-5366
(470) 809-1582
Mailing address
PO BOX 1157, JACKSON, GA 30233-0024
(706) 325-6971
(470) 809-1582
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
Primary
PT008390
GA
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
PT008390
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003175864A
—
GA
Enumeration date
12/12/2013
Last updated
04/06/2026
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