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General NPI Number Information
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NPI Number | 1437697059
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Entity Type | Organization
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Legal Business Name | DRIVE PHYSICAL THERAPY
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Dates
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Enumeration Date | 02/02/2017
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Last Update Date | 02/02/2017
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Provider Practice Location Address
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Address Line | 6151 C DURHAM DR
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City | LAKE WORTH
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State | FL
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Zip | 33467-8714
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Country | US
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Telephone | 561-424-6659
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Fax | 877-992-7402
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Provider Business Mailing Address
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Address Line | PO BOX 742653
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City | BOYNTON BEACH
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State | FL
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Zip | 33474-2653
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Country | US
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Telephone | 561-424-6659
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Fax | 877-992-7402
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Authorized Official
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Title or Position | OWNER
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Name | DR. AMY KUSHNER
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Credential | PT
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Telephone | 561-424-6659
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT27254
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License Number State | FL
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