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General NPI Number Information
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NPI Number | 1629810106
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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 | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 30 GICK RD STE 102
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-8517
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Country | US
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Telephone | 914-557-9613
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Fax |
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Provider Business Mailing Address
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Address Line | 35 SHERWOOD TRL
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-6147
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Country | US
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Telephone | 914-557-9613
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | ALBERT SMALL III
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Credential | DPT
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Telephone | 914-557-9613
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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 |
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License Number State |
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