Organization
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Active
Organization
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Active
Other names
BenchMark Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-7217
Entity
Organization
Contact information
Practice address
1394 BATTLEFIELD PKWY, FORT OGLETHORPE, GA 30742-4010
(706) 858-0252
(706) 858-0323
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
(423) 238-7217
(423) 238-3473
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
225XE1200X
Ergonomics Occupational Therapist
—
—
225XH1200X
Hand Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CK9204
RAILROAD MEDICARE
GA
01
—
CK9205
RAILROAD MEDICARE
GA
Enumeration date
05/16/2006
Last updated
09/20/2017
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