A Physical Therapy Facility License Is Required If

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A Physical Therapy Facility License is Required If: A Comprehensive Guide



Author: Dr. Anya Sharma, PT, DPT, OCS – Dr. Sharma is a licensed physical therapist with over 15 years of experience, specializing in orthopedic physical therapy and practice management. She holds a Doctorate in Physical Therapy and is a board-certified orthopedic clinical specialist. She has extensive knowledge of healthcare regulations and licensing requirements.


Publisher: The American Physical Therapy Association (APTA) – The APTA is the national professional organization representing more than 100,000 physical therapists, physical therapist assistants, and students of physical therapy in the United States. Their publications are widely respected within the healthcare and regulatory fields.


Editor: Mr. David Miller, JD, MHA – Mr. Miller is a healthcare attorney with over 20 years of experience advising healthcare providers on regulatory compliance, including licensing and operational issues. He has a deep understanding of state-specific regulations related to physical therapy practice.


Keyword: a physical therapy facility license is required if


Introduction: Navigating the Complexities of Physical Therapy Facility Licensing




The healthcare landscape is highly regulated, and physical therapy is no exception. Understanding the licensing requirements for establishing and operating a physical therapy facility is crucial for practitioners aiming to provide services legally and ethically. A physical therapy facility license is required if you intend to provide physical therapy services in a designated space, whether it's a private clinic, a hospital department, or a specialized rehabilitation center. This report delves into the intricacies of these requirements, providing clarity on the circumstances under which a license is mandatory and the potential consequences of non-compliance.


What Constitutes a Physical Therapy Facility?




Before exploring when a license is required, it's important to define what constitutes a "physical therapy facility." A physical therapy facility is any location where physical therapy services are provided to patients. This definition extends beyond the traditional brick-and-mortar clinic. A physical therapy facility license is required if you offer services in:


Dedicated Clinics: Stand-alone clinics specifically designed for physical therapy treatments.
Hospital-Based Departments: Physical therapy units within hospitals or medical centers.
Outpatient Rehabilitation Centers: Facilities offering a range of rehabilitation services, including physical therapy.
Mobile Physical Therapy Units: Services provided in patients' homes or other locations (often requiring specific permits in addition to the facility license).
Shared Spaces: Even if the space is shared with other healthcare providers, a separate physical therapy facility license might be required depending on state regulations.


When is a Physical Therapy Facility License Required?




A physical therapy facility license is required if the following conditions are met:


Direct Patient Care: The facility provides direct patient care services, including assessments, treatments, and rehabilitation programs.
Regular Provision of Services: The facility provides physical therapy services on a regular and ongoing basis, not just sporadically.
Physical Location: The services are provided at a specific, identifiable physical location, even if it’s a patient's home for mobile services (in most cases).
Independent Practice: The services are offered independently, not under the direct supervision and license of another entity (like a hospital). However, even hospital-based facilities usually require separate licenses.


State-Specific Variations: It is crucial to understand that licensing requirements vary significantly from state to state. While the general principles remain consistent, the specific criteria, application processes, and continuing education requirements differ substantially. A physical therapy facility license is required if the state in which the facility operates mandates it. This necessitates meticulous research of the relevant state regulations. Failure to comply can result in hefty fines, suspension of practice, and even legal action.


The Licensing Process: A Step-by-Step Guide




The process of obtaining a physical therapy facility license typically involves:


1. Application Submission: Completing a detailed application form, providing information about the facility, its ownership, staffing, and services offered.
2. Facility Inspection: An on-site inspection of the proposed facility to ensure compliance with state regulations concerning space, equipment, safety, and accessibility.
3. Background Checks: Background checks on all owners, practitioners, and key personnel to ensure no history of malpractice or criminal offenses.
4. Compliance Documentation: Providing evidence of compliance with all relevant regulations, including those related to infection control, emergency procedures, and record-keeping.
5. Fees and Payments: Submitting the required application fees and any other necessary payments.


Consequences of Operating Without a License




Operating a physical therapy facility without the required license carries severe consequences, including:


Legal Penalties: Significant fines and potential legal action.
Insurance Issues: Inability to obtain liability insurance, leaving the facility vulnerable to financial ruin in the event of malpractice claims.
Reimbursement Challenges: Difficulties in receiving reimbursement from insurance companies and government programs.
Reputational Damage: Severe damage to the reputation of the facility and its practitioners.


Staying Compliant: Ongoing Requirements




Even after obtaining a license, ongoing compliance is crucial. A physical therapy facility license is required to be maintained through regular renewals, adherence to evolving regulations, and continuous professional development for staff.


Conclusion




A physical therapy facility license is required if the facility provides direct patient care in a specific location on a regular basis, and this requirement is mandated by the governing state. Understanding these regulations is essential for establishing and maintaining a successful and legally compliant physical therapy practice. Ignoring these requirements can lead to severe consequences, impacting both the financial stability and ethical standing of the practice. Always consult with legal professionals and relevant state regulatory bodies to ensure complete compliance.


Frequently Asked Questions (FAQs)




1. Can I practice physical therapy from my home without a facility license? This depends on the state regulations. Some states may allow limited home-based practice under specific conditions, while others strictly require a facility license for any physical therapy services provided.

2. What if I only treat a few patients in a shared space? Even limited use of a space for providing physical therapy services may still require a facility license, depending on state regulations.

3. How often do I need to renew my facility license? Renewal frequencies vary by state, typically ranging from one to two years.

4. What happens if my facility license is revoked? Revocation means you are no longer legally permitted to operate as a physical therapy facility. You may face legal penalties and will need to address the reasons for revocation before reapplying.

5. Do I need a separate license for each location? Yes, typically a separate license is required for each physical location where physical therapy services are provided.

6. What types of insurance are needed for a physical therapy facility? Liability insurance is essential to protect against malpractice claims. Other insurance types might include property insurance and workers' compensation insurance.

7. Who can I contact to get more information on licensing in my state? Contact your state’s board of physical therapy or department of health for specific guidance.

8. What are the typical fees associated with obtaining a physical therapy facility license? Fees vary significantly by state. Check with your state's licensing board for the most current information.

9. Can I appeal a decision to deny my facility license application? Usually, there is an appeals process available if your application is denied. The specifics of this process will be outlined by the licensing board.


Related Articles




1. Navigating the Maze of State Physical Therapy Licensing Laws: This article provides a state-by-state overview of varying regulations and requirements.

2. The Importance of Compliance in Physical Therapy Practice: This article emphasizes the significance of adhering to all regulations to maintain legal and ethical standards.

3. Understanding Malpractice Insurance for Physical Therapists: Explores the types of insurance coverage needed and the importance of sufficient protection.

4. HIPAA Compliance for Physical Therapy Facilities: Focuses on the privacy and security of patient health information and how to meet HIPAA requirements.

5. OSHA Regulations for Physical Therapy Clinics: Details the safety regulations and protocols to ensure a safe work environment for both staff and patients.

6. Effective Record-Keeping in Physical Therapy: Explains best practices for maintaining accurate and comprehensive patient records.

7. Building a Successful Business Plan for a Physical Therapy Clinic: This article provides guidance on creating a solid business plan for starting a physical therapy clinic.

8. Marketing Strategies for Physical Therapy Practices: Discusses effective methods to attract and retain patients for a physical therapy practice.

9. The Role of Continuing Education in Maintaining Physical Therapy Licensure: This article examines the importance of ongoing learning and professional development for both individual therapists and facilities.


  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2012" , 2012 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2015" , 2015 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2011" , 2011 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2010" , 2010 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2007" , 2007 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2013" , 2013 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2014" , 2014 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2008" , 2008 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2009" , 2009 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2006" , 2006 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2016" , 2016 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: The Massachusetts register , 1989
  a physical therapy facility license is required if: Guidelines for Design and Construction of Hospital and Health Care Facilities AIA Academy of Architecture for Health, 2001 Reflecting the most current thinking about infection control and the environment of care, this new edition also explores functional, space, and equipment requirements for acute care and psychiatric hospitals; nursing, outpatient, and rehabilitation facilities; mobile health care units; and facilities for hospice care, adult day care, and assisted living. [Editor, p. 4 cov.]
  a physical therapy facility license is required if: Supervising Physical Therapist National Learning Corporation, 2019-02 The Supervising Physical Therapist Passbook(R) prepares you for your test by allowing you to take practice exams in the subjects you need to study. It provides hundreds of questions and answers in the areas that will likely be covered on your upcoming exam, including but not limited to; Anatomy and physiology; Principles and practices of physical therapy, including therapeutic methods and equipment; Training of subordinate personnel and students; Supervision; and more.
  a physical therapy facility license is required if: Physical Therapist Assistant Exam , 2010 Practical Spelling features key rules of spelling, hundreds of practice exercises, and advice on how to use individual learning styles and strengths to remember difficult words.
  a physical therapy facility license is required if: Guide to Physical Therapist Practice American Physical Therapy Association (1921- ), 2001-01-01 This text guides patterns of practice; improves quality of care; promotes appropriate use of health care services; and explains physical therapist practice to insurers, policymakers, and other health care professionals. This edition continues to be a resource for both daily practice and professional education.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 1997" , 1997 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2000" , 2000 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2001" , 2001 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 2002" , 2002 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: United States Code United States, 1995
  a physical therapy facility license is required if: California. Court of Appeal (2nd Appellate District). Records and Briefs California (State)., Number of Exhibits: 1 Received document entitled: LETTER BRIEF
  a physical therapy facility license is required if: Federal Services to Special Education and Rehabilitation United States. Congress. House. Committee on Education and Labor, 1960
  a physical therapy facility license is required if: Understanding Provider-Based Status Cherilyn G. Murer, Michael A. Murer, Lyndean Lenhoff Brick, 2003-01-01
  a physical therapy facility license is required if: The Code of Federal Regulations of the United States of America , 1967 The Code of Federal Regulations is the codification of the general and permanent rules published in the Federal Register by the executive departments and agencies of the Federal Government.
  a physical therapy facility license is required if: Code of Federal Regulations , 2000 Special edition of the Federal Register, containing a codification of documents of general applicability and future effect ... with ancillaries.
  a physical therapy facility license is required if: Health Facility Surveyor Training United States. Health Standards and Quality Bureau, 1990
  a physical therapy facility license is required if: The PTA Handbook Kathleen A. Curtis, Peggy DeCelle Newman, 2024-06-01 The updated Second Edition of The PTA Handbook is a unique textbook that serves students from pre-admission into a physical therapist assistant program, through the academic program, up to career entry and practice as a physical therapist assistant. Dr. Kathleen A. Curtis and Peggy DeCelle Newman have updated this Second Edition to reflect current practice standards, including updated core professional documents addressing direction and supervision to align with developments in the physical therapy profession. The PTA Handbook, Second Edition expands on the popular first edition and includes an overview of the physical therapy profession, the physical therapist (PT) – physical therapist assistant (PTA) preferred relationship, evidenced-based practice and information literacy, diversity and cultural proficiency, and planning for life-long learning and leadership development. What is new in the Second Edition: • Includes key documents that guide the provision of physical therapy services and describe the relationship between delivery of care by the PT and PTA • Career development strategies for the PTA, including criteria for Recognition of Advanced Proficiency for the Physical Therapist Assistant and leadership roles in professional, clinical, and community contexts • Case studies and “Putting It Into Practice” exercises are user-friendly, realistic approaches to enhance student learning and comprehension through immediate and meaningful application of the topic being discussed • Written as a strategy-based guide to success for PTA students in meeting the required demands and expectations during a PTA program as well as in practice in the field The PTA Handbook, Second Edition also covers information that will assist advisors and counselors in college and work re-entry programs to provide guidance regarding the physical therapy profession and specifically the differing roles of the PTA and PT. This text will also serve as a key guide for groups of 21st century learners frequently seeking PTA education, including first-generation college students, adult learners, career re-entry, second-language learners, and learners with disabilities. The PTA Handbook: Keys to Success in School and Career for the Physical Therapist Assistant, Second Edition is an essential reference for students, educators, advisors and counselors, and therapy managers who want to maximize the potential for success of the PTA.
  a physical therapy facility license is required if: Health Professions Education Institute of Medicine, Board on Health Care Services, Committee on the Health Professions Education Summit, 2003-07-01 The Institute of Medicine study Crossing the Quality Chasm (2001) recommended that an interdisciplinary summit be held to further reform of health professions education in order to enhance quality and patient safety. Health Professions Education: A Bridge to Quality is the follow up to that summit, held in June 2002, where 150 participants across disciplines and occupations developed ideas about how to integrate a core set of competencies into health professions education. These core competencies include patient-centered care, interdisciplinary teams, evidence-based practice, quality improvement, and informatics. This book recommends a mix of approaches to health education improvement, including those related to oversight processes, the training environment, research, public reporting, and leadership. Educators, administrators, and health professionals can use this book to help achieve an approach to education that better prepares clinicians to meet both the needs of patients and the requirements of a changing health care system.
  a physical therapy facility license is required if: Fundamental Orthopedic Management for the Physical Therapist Assistant Robert C. Manske, 2015-05-22 - NEW Differential Diagnosis and Emergent Conditions chapter shows how similar symptoms can mask potentially dangerous pathologies and conditions, and may require re-evaluation by the supervising therapist. - NEW Musculoskeletal Imaging chapter explains in basic terms the various types of musculoskeletal imaging used when examining musculoskeletal injuries. - NEW Orthopedic Management Concepts Specific to Women chapter covers the issues, pathology, and progression of women's health issues as they relate to physical rehabilitation. - NEW! Full-color design and illustrations add clarity to anatomy and procedural drawings and make it easier to learn important concepts. - NEW! Important Concepts highlight useful tips and tricks of patient practice. - NEW student resources on the Evolve companion website include critical thinking applications, weblinks to related sites, and references with links to Medline® abstracts.
  a physical therapy facility license is required if: Legal Medicine - E-BOOK American College of Legal Medicine, American Board of Legal Medicine, 2024-05-29 Authored by the two primary organizations in the field, Legal Medicine: Health Care Law and Medical Ethics, 8th Edition, remains the premier treatise in this increasingly important area of medical practice. In the midst of a progressively litigious culture, this essential reference provides up-to-date information on topics surrounding professional medical liability, the business aspects of medical practice, and medicolegal and ethical issues, offering comprehensive discussions on a myriad of topics that health care professionals face every day. - Addresses the legal aspects of almost every medical topic that impacts health care professionals, using actual case studies to illustrate nuances in the law. - Offers the expert guidance of top professionals across medical and legal fields in an easy-to-read format. - Includes new chapters on Legal Medicine History; Healthcare Technology; Patients with Infectious Diseases (HIV Infection and COVID-19); General Pain Management; Opioids and Illicit Drugs: Misuse, Abuse and Addiction; Cannabis (Marijuana); Drug (Treatment) Courts; and Public Health Law and Policy. - Provides authoritative information on current issues such as the high costs of medical liability insurance for practitioners and organizations; changes in health care and the law, including HIPAA and patient privacy; the overturning of Roe v. Wade; the opioid epidemic, and more. - Features Key Points boxes to open every chapter, Pearls boxes to call out important details, additional diagrams and tables throughout, a glossary of medical terms, and updated references and suggested readings. - Serves as the syllabus for the Board Review Course of the American Board of Legal Medicine (ABLM).
  a physical therapy facility license is required if: Committee Prints United States. Congress. House. Committee on Education and Labor, 1960
  a physical therapy facility license is required if: Senate Bill California. Legislature. Senate, 1987
  a physical therapy facility license is required if: Federal Register , 1969-10
  a physical therapy facility license is required if: Quick Reference Dictionary for Physical Therapy Jennifer Bottomley, 2024-06-01 Quick Reference Dictionary for Physical Therapy has been revised and updated into a Third Edition to include the latest information in the field of physical therapy. This reference book, designed specifically for the physical therapy and physical therapist assistant student and practitioner, provides a magnitude of terms, definitions, guidelines, and references essential to the field. This Third Edition provides quick access to over 3400 words and their definitions that are encountered on a day-to-day basis (400 more than the previous edition). There are also 41 appendices in this user-friendly, pocket-sized reference where you can find information such as lists of general acronyms and abbreviations for words commonly used in physical therapy/rehabilitation; commonly used acronyms for evaluative tests and measures; and definitions of impairment, disability, and handicap as established and accepted by the World Health Organization. What is new inside the Third Edition:• More than 100 new abbreviations and acronyms • Updated Code of Ethics for the Physical Therapist• A new Drug Prescribing and Elimination Abbreviations appendix • Updates to suggested readings Quick Reference Dictionary for Physical Therapy, Third Edition is the perfect, pocket size, affordable companion for school, clinical affiliations, and physical therapy practice.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 1995" , 1995 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: Journal of the Assembly, Legislature of the State of California California. Legislature. Assembly, 1979
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 1998" , 1998 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
  a physical therapy facility license is required if: Wellness and Physical Therapy Fair, Sharon Elayne Fair, 2010-10-22 The focus of Wellness and Physical Therapy will be the application of wellness, particularly fitness wellness, to the practice and profession of physical therapy. The book addresses all items related to wellness in the Normative Model of Physical Therapist Professional Education: Version 2004, the Guide to Physical Therapist Practice, and APTA’s Education Strategic Plan. The text consists of foundational knowledge, theoretical models, empirical research and application of material to physical therapy practice. Evidence-based practice is emphasized through a mixed approach of formalist and reader-response. An important text for all physical therapy students! Important Notice: The digital edition of this book is missing some of the images or content found in the physical edition.
  a physical therapy facility license is required if: "Code of Massachusetts regulations, 1994" , 1994 Archival snapshot of entire looseleaf Code of Massachusetts Regulations held by the Social Law Library of Massachusetts as of January 2020.
Advanced Spine, Sports, & Orthopaedic Specialists - MVP Physio Dr
Jun 9, 2023 · Our physical therapy treatments get you back to moving pain-free, with better range of motion, strength, balance, coordination, and energy. We will get you back to your daily life, …

PHYSICAL Definition & Meaning - Merriam-Webster
material, physical, corporeal, phenomenal, sensible, objective mean of or belonging to actuality. material implies formation out of tangible matter; used in contrast with spiritual or ideal it may …

Physical Therapy in Macon and Warner Robins - OrthoGeorgia
Our physical therapy locations utilize state of the art equipment and are staffed by licensed physical therapists and physical therapist assistants who provide the highest quality of care for …

PHYSICAL | English meaning - Cambridge Dictionary
(Definition of physical from the Cambridge Advanced Learner's Dictionary & Thesaurus © Cambridge University Press)

Physical (TV Series 2021–2023) - IMDb
Physical: Created by Annie Weisman. With Rose Byrne, Rory Scovel, Dierdre Friel, Paul Sparks. A woman struggling in her life as a quietly tortured housewife finds an unconventional path to …

Physical - definition of physical by The Free Dictionary
physical - involving the body as distinguished from the mind or spirit; "physical exercise"; "physical suffering"; "was sloppy about everything but her physical appearance"

PHYSICAL Definition & Meaning | Dictionary.com
Physical, bodily, corporeal, corporal agree in pertaining to the body. Physical indicates connected with, pertaining to, the animal or human body as a material organism: physical strength, exercise.

Physical or Physical – Which is Correct? - Two Minute English
May 27, 2025 · The correct word is physical. “Physical” refers to anything related to the body or material substances. For example, “physical exercise” means activities that involve body …

PHYSICAL definition and meaning | Collins English Dictionary
Physical means relating to the structure, size, or shape of something that can be touched and seen.

Physical Therapy & Wellness- Warner Robins, Macon, Perry
The Cantrell Center in Warner Robins, Georgia has been providing excellent physical therapy treatment to Middle Georgians for over 30 years.

Advanced Spine, Sports, & Orthopaedic Specialists - MVP Physio Dr
Jun 9, 2023 · Our physical therapy treatments get you back to moving pain-free, with better range of motion, strength, balance, coordination, and energy. We will get you back to your daily life, …

PHYSICAL Definition & Meaning - Merriam-Webster
material, physical, corporeal, phenomenal, sensible, objective mean of or belonging to actuality. material implies formation out of tangible matter; used in contrast with spiritual or ideal it may …

Physical Therapy in Macon and Warner Robins - OrthoGeorgia
Our physical therapy locations utilize state of the art equipment and are staffed by licensed physical therapists and physical therapist assistants who provide the highest quality of care for …

PHYSICAL | English meaning - Cambridge Dictionary
(Definition of physical from the Cambridge Advanced Learner's Dictionary & Thesaurus © Cambridge University Press)

Physical (TV Series 2021–2023) - IMDb
Physical: Created by Annie Weisman. With Rose Byrne, Rory Scovel, Dierdre Friel, Paul Sparks. A woman struggling in her life as a quietly tortured housewife finds an unconventional path to …

Physical - definition of physical by The Free Dictionary
physical - involving the body as distinguished from the mind or spirit; "physical exercise"; "physical suffering"; "was sloppy about everything but her physical appearance"

PHYSICAL Definition & Meaning | Dictionary.com
Physical, bodily, corporeal, corporal agree in pertaining to the body. Physical indicates connected with, pertaining to, the animal or human body as a material organism: physical strength, exercise.

Physical or Physical – Which is Correct? - Two Minute English
May 27, 2025 · The correct word is physical. “Physical” refers to anything related to the body or material substances. For example, “physical exercise” means activities that involve body …

PHYSICAL definition and meaning | Collins English Dictionary
Physical means relating to the structure, size, or shape of something that can be touched and seen.

Physical Therapy & Wellness- Warner Robins, Macon, Perry
The Cantrell Center in Warner Robins, Georgia has been providing excellent physical therapy treatment to Middle Georgians for over 30 years.