Healthcare Provider Details

I. General information

NPI: 1306450101
Provider Name (Legal Business Name): THRIVE PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2020
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 DARO CT
MONTVILLE NJ
07045-9347
US

IV. Provider business mailing address

14 DARO CT
MONTVILLE NJ
07045-9347
US

V. Phone/Fax

Practice location:
  • Phone: 973-224-3108
  • Fax:
Mailing address:
  • Phone: 973-224-3108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: NEHA MEHTA
Title or Position: OWNER
Credential: DPT
Phone: 973-224-3108