MEDICARE: THRIVE CHIROPRACTIC NORTH LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHR.0007560	CO

General Provider Information

NPI Number	:	1437696846
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THRIVE CHIROPRACTIC NORTH LLC

Provider Business Mailing Address
First Line	:	2721 S COLLEGE AVE
Second Line	:	SUITE 4A
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2199
Country	:	US
Telephone Number	:	952-210-2108
Fax Number	:

Provider Business Practice Location Address
First Line	:	2721 S COLLEGE AVE
Second Line	:	UNIT 4A
City	:	FORT COLLINS
State	:	CO
Zip	:	80525-2199
Country	:	US
Telephone Number	:	952-210-2108
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR/OWNER
Name	:	DR. PATRICK ARTHUR ISAACS
Credential	:	D.C.
Telephone Number	:	952-210-2108

Provider Enumeration Date	:	01/23/2017
Last Update Date	:	01/23/2017

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