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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | Yes | ||
| Occupational Therapist |
225X00000X | |||
| Speech-Language Pathologist |
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
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- John W. Davis, DC, PA
- Asim Kidwai
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All providers in East Ellijay, 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 May 9, 2017. 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.