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NPI Code Detail

MEDICARE: INDEPENDENT PHYSICAL THERAPY LLC

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

General Provider Information

NPI Number : 1205003118
Entity Type Code : Organization
Provider Name (Legal Business Name) : INDEPENDENT PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 6397 LEE HWY STE 300
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37421-4915
Country : US
Telephone Number : 423-238-7217
Fax Number : 423-238-3473
Provider Business Practice Location Address
First Line : 311 CONGRESS PKWY N STE 800
Second Line :
City : ATHENS
State : TN
Zip : 37303-1697
Country : US
Telephone Number : 423-744-0890
Fax Number : 423-744-0849
Authorized Official
Title or Position : VP REVENUE CYCLE
Name : KEVIN JOHANNESON
Credential :
Telephone Number : 423-238-7217
Provider Enumeration Date : 05/09/2008
Last Update Date : 11/14/2019

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Directions to “INDEPENDENT PHYSICAL THERAPY LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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