Independent Physical Therapy of Ga, LLC

Organization Active NPI Physical Therapist · Jefferson, GA

NPI 1407080740 · NPPES record last updated Oct 19, 2017

Key facts

NPI
1407080740
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GA, LLC
Practice address
1689 Old Pendergrass Rd Ste 300
Jefferson, GA 30549-2716
Phone
(706) 387-0212
Fax
(706) 387-0213
NPI assigned
May 14, 2009
Organization subpart
No

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-8923

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
225100000X Yes
Occupational Therapist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
225X00000X
Speech-Language Pathologist
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
235Z00000X

Addresses

Primary practice location

1689 Old Pendergrass Rd Ste 300
Jefferson, GA 30549-2716

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Other names

  • BENCHMARK PT Doing business as

Other providers in Jefferson, GA

All providers in Jefferson, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.