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General NPI Number Information
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NPI Number | 1710251707
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Entity Type | Organization
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Legal Business Name | THRIVING LIFE CARE CHIROPRACTIC INC.
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Dates
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Enumeration Date | 03/08/2012
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Last Update Date | 03/08/2012
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Provider Practice Location Address
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Address Line | 260 S SUNNYVALE AVE STE 1
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City | SUNNYVALE
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State | CA
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Zip | 94086-6273
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Country | US
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Telephone | 408-329-9604
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Fax | 408-262-1321
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Provider Business Mailing Address
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Address Line | 260 S SUNNYVALE AVE STE 1
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City | SUNNYVALE
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State | CA
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Zip | 94086-6273
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Country | US
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Telephone | 408-329-9604
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Fax | 408-262-1321
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Authorized Official
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Title or Position | CHIROPRACTOR/MANAGING DIRECTOR
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Name | MS. HELEN WANG
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Credential | D.C.
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Telephone | 408-329-9604
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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 | 30196
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 30364
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License Number State | CA
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