| Entity Name: | DRIVEN PHYSICAL THERAPY, LLC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Florida Limited Liability Co. |
| Status: | Active |
| Date Filed: | 22 Feb 2022 (3 years ago) |
| Document Number: | L22000085971 |
| FEI/EIN Number | 88-1001023 |
| Address: | 14597 ZACHARY DR S, JACKSONVILLE, FL, 32218, US |
| Mail Address: | 14597 ZACHARY DR S, JACKSONVILLE, FL, 32218, US |
| ZIP code: | 32218 |
| County: | Duval |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1427706373 | 2022-03-10 | 2022-03-10 | 14597 ZACHARY DR S, JACKSONVILLE, FL, 322180852, US | 14597 ZACHARY DR S, JACKSONVILLE, FL, 322180852, US | |||||||||||||
|
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| Phone | +1 402-312-1574 |
Authorized person
| Name | NOEL WAGNER |
| Role | OWNER/PHYSICAL THERAPIST |
| Phone | 4023121574 |
Taxonomy
| Taxonomy Code | 225200000X - Physical Therapy Assistant |
| Is Primary | Yes |
| Name | Role | Address |
|---|---|---|
| WAGNER NOEL | Agent | 14597 ZACHARY DR S, JACKSONVILLE, FL, 32218 |
| Name | Role | Address |
|---|---|---|
| WAGNER NOEL | Manager | 14597 ZACHARY DR S, JACKSONVILLE, FL, 32218 |
| Name | Date |
|---|---|
| ANNUAL REPORT | 2024-02-07 |
| ANNUAL REPORT | 2023-04-28 |
| Florida Limited Liability | 2022-02-22 |
Date of last update: 01 Feb 2025
Sources: Florida Department of State
