Healthcare Provider Details

I. General information

NPI: 1043831001
Provider Name (Legal Business Name): THRIVE NOW THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2020
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9624 BAILEY RD STE 273
CORNELIUS NC
28031-6120
US

IV. Provider business mailing address

9624 BAILEY RD STE 273
CORNELIUS NC
28031-6120
US

V. Phone/Fax

Practice location:
  • Phone: 704-980-0680
  • Fax:
Mailing address:
  • Phone: 704-980-0680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. BRENT WILLIAM PORTER
Title or Position: OCCUPATIONAL THERAPIST
Credential: OTR/L
Phone: 704-980-0680