Provider Demographics
NPI:1053156224
Name:THRIVE CHIROPRACTIC WELLNESS LLC
Entity type:Organization
Organization Name:THRIVE CHIROPRACTIC WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BENEFICIAL OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:440-221-2251
Mailing Address - Street 1:1887 WESTWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1249
Mailing Address - Country:US
Mailing Address - Phone:440-221-2251
Mailing Address - Fax:
Practice Address - Street 1:8900 DARROW RD STE H102
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-6801
Practice Address - Country:US
Practice Address - Phone:440-221-2251
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-28
Last Update Date:2024-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Single Specialty