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
National Provider Directory
- Tax ID family
- Independent Physical TH
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
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
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All providers in Lilburn, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 23, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.