OrganizationActive
Independent Physical Therapy, LLC
NPI 1851643944 · Physical Therapy Clinic/Center · Woodstock, GA
Provider details
- NPI number
- 1851643944
- Entity type
- Organization
- Primary specialty
- Physical Therapy Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Marvette Wallace, Director of Contract Management(423) 238-7217
Specialties & taxonomies
Ambulatory Health Care Facilities
- Multi-Specialty Clinic/Center261QM1300X
Ambulatory Health Care Facilities
- Occupational Medicine Clinic/Center261QX0100X
Ambulatory Health Care Facilities
Profile Score
Detailed profile(79/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2295 Towne Lake Pkwy Ste 148
Woodstock, GA 30189-5520
Phone: (770) 926-2744
Fax: (770) 926-2794
Street-level locationGet directions
Mailing address
8823 Production Ln
Ooltewah, TN 37363-6511
Registry dates
- Enumerated
- 2012-10-12
- Last updated
- 2012-10-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.