Organization
INDEPENDENT PHYSICAL THERAPY OF GA, 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
863 W OGLETHORPE HWY STE 210, HINESVILLE, GA 31313-4491
(888) 578-5231
(888) 629-0078
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
12/06/2017
Last updated
12/06/2017
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