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NPI Code Detail

MEDICARE: INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC

MEDICARE: INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist
2235Z00000XSpeech-Language Pathologist
3225100000XPhysical Therapist

General Provider Information

NPI Number : 1124295779
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDEPENDENT PHYSICAL THERAPY OF GEORGIA, 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 : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 5415 THOMPSON MILL RD
Second Line :
City : HOSCHTON
State : GA
Zip : 30548-4132
Country : US
Telephone Number : 770-965-3508
Fax Number : 770-965-3279
Authorized Official
Title or Position : CFO
Name : BRYAN BARGANIER
Credential :
Telephone Number : 205-536-7602
Provider Enumeration Date : 05/13/2008
Last Update Date : 04/20/2021

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Directions to “INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC ” Practice Location

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