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General NPI Number Information
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NPI Number | 1538018015
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Entity Type | Organization
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Legal Business Name | THRIV 360 FIVE PRECISION DIAGNOSTICS, LLC
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Dates
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Enumeration Date | 01/27/2026
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Last Update Date | 01/27/2026
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Provider Practice Location Address
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Address Line | 100 RICE MINE ROAD LOOP STE 101
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2424
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Country | US
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Telephone | 205-790-2900
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Fax |
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Provider Business Mailing Address
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Address Line | 100 RICE MINE ROAD LOOP STE 101
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City | TUSCALOOSA
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State | AL
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Zip | 35406-2424
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Country | US
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Telephone | 205-790-2900
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | WENDELL GIBSON
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Credential |
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Telephone | 205-790-2900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number |
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License Number State |
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