NPIMap

Independent Physical Therapy of Ga LLC

Organization Active NPI Physical Therapist · Bremen, GA

NPI 1023640752 · NPPES record last updated Feb 11, 2020

Key facts

NPI
1023640752
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GA LLC
Practice address
215 Davis Blvd
Bremen, GA 30110-2569
Phone
(770) 111-4455
NPI assigned
Feb 11, 2020
Organization subpart
No

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-2313

Corporate family (same tax ID) 21

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Independent Physical TH (161 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP		 225X00000X
Speech-Language Pathologist
Group: 193200000X MULTI-SPECIALTY GROUP		 235Z00000X

Addresses

Primary practice location

215 Davis Blvd
Bremen, GA 30110-2569

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915

Other providers in Bremen, GA

All providers in Bremen, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.