Provider Demographics
NPI:1679279889
Name:DRIVEN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:DRIVEN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:DREW
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:229-247-4436
Mailing Address - Street 1:326 AVENUE OF OAKS
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-1826
Mailing Address - Country:US
Mailing Address - Phone:229-251-1478
Mailing Address - Fax:
Practice Address - Street 1:28 HOLLY CREEK DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:229-251-1478
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-31
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty