MEDICARE: INDEPENDENT PHYSICAL THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	235Z00000X	Speech-Language Pathologist
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1144497868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDEPENDENT PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	232-387-2174
Fax Number	:	423-238-3473

Provider Business Practice Location Address
First Line	:	3849 DAYTON BLVD STE 109
Second Line	:
City	:	CHATTANOOGA
State	:	TN
Zip	:	37415-4044
Country	:	US
Telephone Number	:	423-877-5817
Fax Number	:	423-877-7170

Authorized Official
Title or Position	:	CFO
Name	:	BRYAN BARGANIER
Credential	:
Telephone Number	:	205-536-7602

Provider Enumeration Date	:	05/12/2008
Last Update Date	:	06/28/2021

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