Independent Physical Therapy of Ga, LLC

Organization Active NPI Physical Therapist · McDonough, GA

NPI 1477906006 · NPPES record last updated Jul 19, 2016

Key facts

NPI
1477906006
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GA, LLC
Practice address
898 Hampton Rd
McDonough, GA 30253-6514
Phone
(678) 583-9954
Fax
(678) 583-8709
NPI assigned
Jul 19, 2016
Organization subpart
No

Authorized official

Name
Kevin Johanneson
Title
VP of Revenue Cycle
Phone
(423) 238-3220

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
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

898 Hampton Rd
McDonough, GA 30253-6514

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511

Other names

  • BenchMark PT - McDonough Doing business as

Other providers in McDonough, GA

All providers in McDonough, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.