Organization
DRIVE PHYSICAL THERAPY AND PERFORMANCE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW ZIS P.T, DPT (OWNER/FOUNDER)
(845) 772-1374
Entity
Organization
Contact information
Practice address
700 HOLCOMB BRIDGE RD STE 200, ROSWELL, GA 30076-1630
(845) 772-1374
Mailing address
136 MILLSTONE WAY, CANTON, GA 30115-7270
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1831625359
NONE AFFILIATED
—
Enumeration date
10/29/2019
Last updated
10/29/2019
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