Independent Physical Therapy of Ga LLC

Organization Active NPI Physical Therapist · Lilburn, GA

NPI 1578064754 · NPPES record last updated Feb 23, 2018

Key facts

NPI
1578064754
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GA LLC
Practice address
4145 Lawrenceville Hwy NW Ste 8
Lilburn, GA 30047-2807
Phone
(423) 123-4567
NPI assigned
Feb 23, 2018
Organization subpart
No

Authorized official

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

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

4145 Lawrenceville Hwy NW Ste 8
Lilburn, GA 30047-2807

Mailing address

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

Other providers in Lilburn, GA

All providers in Lilburn, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.