Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Independent Physical Therapy of Georgia, LLC

Organization Physical Therapist · NPI 1457608861

Independent Physical Therapy of Georgia, LLC is a Physical Therapist in Canton, Georgia. Registered with an NPI since 2012.

In the registry since
2012
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1453 Riverstone Pkwy Ste 170
Canton, GA 30114-5626
Phone: (770) 704-0774
Fax: (770) 704-0779
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Occupational Therapist Taxonomy 225X00000X
Speech-Language Pathologist Taxonomy 235Z00000X

Record details

NPI number1457608861
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kevin Johanneson — Vp Revenue Cycle · (423) 238-8923
NPI enumeratedAugust 6, 2012
Last updated in NPPESMay 10, 2017
Mailing address8823 Production Ln, Ooltewah, TN 37363-6511

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