Organization
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Active
Other names
BenchMark
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-7217
Entity
Organization
Contact information
Practice address
3885 PRINCETON LAKES WAY SW STE 408, ATLANTA, GA 30331-5599
(404) 344-2823
(404) 629-3737
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
(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
—
—
261QX0100X
Occupational Medicine Clinic/Center
—
—
Other
Enumeration date
11/02/2012
Last updated
11/06/2018
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