| Organization Name: | INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC |
| NPI Number: | 1215989413 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | TROY BAGE (PRESIDENT) |
| Mailing Address: | 102 Hines Rd Ne Suite 3 Calhoun |
| State: | GA US |
| Postal Code: | 307019383 |
| Phone Number: | 7066029655 |
| Fax Number: | 7066029676 |
| NPI Enumeration Date: | 05/16/2006 |
| NPI Last Update Date: | 06/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QM1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Multi-Specialty |
| Taxonomy Definition: | |