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General NPI Number Information
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NPI Number | 1053156224
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Entity Type | Organization
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Legal Business Name | THRIVE CHIROPRACTIC WELLNESS LLC
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Dates
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Enumeration Date | 06/28/2024
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Last Update Date | 06/28/2024
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Provider Practice Location Address
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Address Line | 8900 DARROW RD STE H102
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City | TWINSBURG
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State | OH
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Zip | 44087-6801
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Country | US
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Telephone | 440-221-2251
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Fax |
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Provider Business Mailing Address
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Address Line | 1887 WESTWOOD DR
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City | TWINSBURG
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State | OH
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Zip | 44087-1249
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Country | US
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Telephone | 440-221-2251
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Fax |
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Authorized Official
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Title or Position | BENEFICIAL OWNER
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Name | MATTHEW JOHN GRANT
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Credential | DC
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Telephone | 440-221-2251
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NX0100X
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Taxonomy Name | Occupational Health Chiropractor
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License Number |
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License Number State |
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