Independent Physical Therapy of Georgia, LLC

Organization Active NPI Physical Therapist · East Ellijay, GA

NPI 1669729067 · NPPES record last updated May 9, 2017

Key facts

NPI
1669729067
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Practice address
190 Old Orchard SQ
East Ellijay, GA 30540-8172
Phone
(706) 273-3131
Fax
(706) 273-3133
NPI assigned
Aug 6, 2012
Organization subpart
No

Authorized official

Name
Kevin Johanneson
Title
Manager
Phone
(423) 238-7217

National Provider Directory

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

190 Old Orchard SQ
East Ellijay, GA 30540-8172

Mailing address

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

Other providers in East Ellijay, GA

All providers in East Ellijay, GA · Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.