Organization
INDEPENDENT PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN JOHANNESON (VP REVENUE CYCLE)
(423) 238-2313
Entity
Organization
Contact information
Practice address
8618 HIGHWAY 58 STE 103, HARRISON, TN 37341-3910
(833) 588-4556
(833) 588-4557
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-2564
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Enumeration date
04/04/2018
Last updated
04/04/2018
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