Organization
INDEPENDENT PHYSICAL THERAPY OF GA, LLC
Active
Other names
BenchMark PT - Madison
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-7217
Entity
Organization
Contact information
Practice address
1680 EATONTON RD, MADISON, GA 30650-4628
(706) 342-1971
(706) 342-1973
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
02/07/2017
Last updated
02/07/2017
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