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NPI Code Detail

MEDICARE: THRIVE THERAPIES LLC

MEDICARE: THRIVE THERAPIES 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
1225100000XPhysical Therapist
22251P0200XPediatric Physical Therapist
3225X00000XOccupational Therapist
4235Z00000XSpeech-Language Pathologist
5225XP0200XPediatric Occupational Therapist09-0166NV

General Provider Information

NPI Number : 1760842876
Entity Type Code : Organization
Provider Name (Legal Business Name) : THRIVE THERAPIES LLC
Provider Business Mailing Address
First Line : 6363 S PECOS RD STE 104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-6291
Country : US
Telephone Number : 702-565-5011
Fax Number : 702-565-5012
Provider Business Practice Location Address
First Line : 6363 S PECOS RD STE 104
Second Line :
City : LAS VEGAS
State : NV
Zip : 89120-6291
Country : US
Telephone Number : 702-565-5011
Fax Number : 702-565-5012
Authorized Official
Title or Position : OWNER
Name : LACEE BUKOSKEY
Credential : OTR/L
Telephone Number : 702-565-5011
Provider Enumeration Date : 03/02/2016
Last Update Date : 01/25/2022

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Directions to “THRIVE THERAPIES LLC ” Practice Location

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