Healthcare Provider Details
I. General information
NPI: 1639924178
Provider Name (Legal Business Name): THRIVING BABIES THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/18/2024
Last Update Date: 04/18/2024
Certification Date: 04/18/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1127 HELMSDALE DR
FOREST VA
24551-4740
US
IV. Provider business mailing address
1127 HELMSDALE DR
FOREST VA
24551-4740
US
V. Phone/Fax
- Phone: 434-660-3323
- Fax:
- Phone: 434-660-3323
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2251P0200X |
| Taxonomy | Pediatric Physical Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2251X0800X |
| Taxonomy | Orthopedic Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
MORGAN
PFAFF
Title or Position: OWNER/CEO
Credential: PT, DPT
Phone: 434-660-3323