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General NPI Number Information
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NPI Number | 1962873455
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Entity Type | Organization
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Legal Business Name | THRIVE INTEGRATED HEALTH INC
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Dates
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Enumeration Date | 10/09/2015
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Last Update Date | 06/03/2016
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Provider Practice Location Address
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Address Line | 4115 N STEELE BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5318
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Country | US
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Telephone | 479-439-8121
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Fax | 870-551-3726
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Provider Business Mailing Address
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Address Line | 4115 N STEELE BLVD
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City | FAYETTEVILLE
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State | AR
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Zip | 72703-5318
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Country | US
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Telephone | 479-439-8121
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Fax | 870-551-3726
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRETT WHATCOTT
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Credential | D.O.
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Telephone | 479-439-8121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | AR
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