Independent Physical Therapy Of Ga LLC
Physical Therapist in Mableton, GA. Organization (NPI-2).
NPI number1912499054
StatusActive
Last updated in NPPESJun 5, 2018
Details
- NPI
- 1912499054
- Entity type
- Organization (NPI-2)
- Legal business name
- Independent Physical Therapy Of Ga LLC
- Organization subpart
- No
- Enumeration date
- Jun 5, 2018
- Last updated
- Jun 5, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | – | – | Yes |
| 225X00000X | Occupational Therapist | – | – | |
| 235Z00000X | Speech-Language Pathologist, | – | – |
Practice location
1025 Veterans Memorial Hwy Se Ste 640Mableton, GA 30126-7711
Phone 833-881-9256
Mailing address
6397 Lee HwyChattanooga, TN 37421-2564
Authorized official
Kevin Johanneson
Vp Revenue Cycle
4232382313
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