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
1	235Z00000X	Speech-Language Pathologist
2	261QR0400X	Rehabilitation Clinic/Center
3	261QM1300X	Multi-Specialty Clinic/Center
4	225100000X	Physical Therapist
5	261QP2000X	Physical Therapy Clinic/Center
6	225X00000X	Occupational Therapist

General Provider Information

NPI Number	:	1306013941
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	:	1100 SHERWOOD PARK DR NE STE 140
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30501-3426
Country	:	US
Telephone Number	:	770-297-7750
Fax Number	:	770-297-1026

Authorized Official
Title or Position	:	DIRECTOR OF CREDENTIALING
Name	:	LAUREN HILL
Credential	:
Telephone Number	:	972-465-0296

Provider Enumeration Date	:	05/13/2008
Last Update Date	:	09/30/2025

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

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