Organization
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Active
Other names
BenchMark PT
Organization subpart
No
Provider details
NPI number
Authorized official
KILEY RUSSELL (PAYOR RELATIONS COORDINATOR)
(423) 238-8923
Entity
Organization
Contact information
Practice address
4510 NELSON BROGDON BLVD, BUFORD, GA 30518-3478
(770) 945-1045
(770) 945-5745
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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