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General NPI Number Information
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NPI Number | 1114650926
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Entity Type | Organization
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Legal Business Name | THRIVE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 07/08/2022
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Last Update Date | 11/21/2022
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Provider Practice Location Address
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Address Line | 802 MAIN STREET
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City | BURKE
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State | SD
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Zip | 57523
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Country | US
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Telephone | 605-775-2003
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Fax |
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Provider Business Mailing Address
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Address Line | 29241 SOUTH DAKOTA HIGHWAY 47
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City | BURKE
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State | SD
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Zip | 57523
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Country | US
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Telephone | 605-830-0969
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Fax |
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Authorized Official
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Title or Position | CHIROPRACTOR/OWNER
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Name | DR. NATASHA RAE MARTIN
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Credential | DC
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Telephone | 605-830-0969
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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