MEDICARE: THRYVE WELLNESS GROUP LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor

General Provider Information

NPI Number	:	1154965424
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRYVE WELLNESS GROUP LLC

Provider Business Mailing Address
First Line	:	2470 WINDY HILL RD SE STE 250
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30067-8619
Country	:	US
Telephone Number	:	503-803-0044
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 WHITLOCK PL SW STE 100
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-3164
Country	:	US
Telephone Number	:	678-792-0213
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JAMILA FLOWERS
Credential	:
Telephone Number	:	503-803-0044

Provider Enumeration Date	:	10/30/2019
Last Update Date	:	03/20/2024

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