| Organization Name: | INDEPENDENT PHYSICAL THERAPY OF GEORGIA , LLC |
| NPI Number: | 1003868225 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TROY BAGE (PRESIDENT) |
| Mailing Address: | 1508 N Thornton Ave Ste 106 Dalton |
| State: | GA US |
| Postal Code: | 307208516 |
| Phone Number: | 7062260816 |
| Fax Number: | 7062269584 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 06/04/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | 12/21/2006 |
| NPI Reactivation Date: | 05/27/2008 |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |