Healthcare Provider Details

I. General information

NPI: 1598655227
Provider Name (Legal Business Name): THRIVEWELL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2025
Last Update Date: 07/04/2025
Certification Date: 07/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7108 MAIDEN POINT PL
ELKRIDGE MD
21075-6509
US

IV. Provider business mailing address

7108 MAIDEN POINT PL
ELKRIDGE MD
21075-6509
US

V. Phone/Fax

Practice location:
  • Phone: 240-305-1326
  • Fax:
Mailing address:
  • Phone: 240-305-1326
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QX0100X
TaxonomyOccupational Medicine Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: EVANS KEN ADDO
Title or Position: ADMINISTRATOR
Credential:
Phone: 240-305-1326