Independent Physical Therapy of Georgia, LLC

Organization Active NPI Physical Therapy Clinic/Center · Atlanta, GA

NPI 1457511289 · NPPES record last updated Dec 6, 2016

Key facts

NPI
1457511289
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Practice address
800 Peachtree St NE
Ste E2
Atlanta, GA 30308-1245
Phone
(404) 523-7709
Fax
(404) 523-1065
NPI assigned
Jun 16, 2008
Organization subpart
No

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-7217

Corporate family (same tax ID) 24

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
Multi-Specialty Clinic/Center 261QM1300X
Physical Therapy Clinic/Center 261QP2000X Yes
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

800 Peachtree St NE
Ste E2
Atlanta, GA 30308-1245

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other identifiers

IdentifierTypeStateIssuer
CK9205OtherGARAILROAD MEDICARE

Other names

  • BenchMark Physical Therapy Other name

Other providers in Atlanta, GA

All providers in Atlanta, GA · Physical Therapy Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.