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General NPI Number Information
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NPI Number | 1063841278
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Entity Type | Organization
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Legal Business Name | THRIVE WELLNESS CENTER PC
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Dates
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Enumeration Date | 11/07/2013
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Last Update Date | 11/07/2013
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Provider Practice Location Address
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Address Line | 6901 STATE RD STE D
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City | SALINE
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State | MI
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Zip | 48176-8930
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Country | US
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Telephone | 734-470-6766
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Fax |
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Provider Business Mailing Address
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Address Line | 6901 STATE RD STE D
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City | SALINE
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State | MI
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Zip | 48176-8930
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Country | US
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Telephone | 734-470-6766
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SHANNON ROZNAY
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Credential | DC
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Telephone | 734-470-6766
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NN1001X
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Taxonomy Name | Nutrition Chiropractor
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License Number | 2301008957
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License Number State | MI
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