Healthcare Provider Details

I. General information

NPI: 1649647710
Provider Name (Legal Business Name): THRIVE CHIROPRACTIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2015
Last Update Date: 08/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 PAINE ST SE SUITE A
BONDURANT IA
50035-1154
US

IV. Provider business mailing address

1825 SW WHITE BIRCH CIR UNIT 16
ANKENY IA
50023-7205
US

V. Phone/Fax

Practice location:
  • Phone: 989-934-0770
  • Fax:
Mailing address:
  • Phone: 989-934-0770
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number079049
License Number StateIA

VIII. Authorized Official

Name: DR. MIRANDA L SCHMITT
Title or Position: CHIROPRACTOR
Credential: D.C.
Phone: 989-934-0770