Provider Demographics
NPI:1053956631
Name:THRIVE INTEGRATIVE PHYSICAL THERAPY AND SPORTS REHAB, LLC
Entity type:Organization
Organization Name:THRIVE INTEGRATIVE PHYSICAL THERAPY AND SPORTS REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:JOYNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:540-535-6120
Mailing Address - Street 1:251 COMMONWEALTH CT
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-5347
Mailing Address - Country:US
Mailing Address - Phone:540-532-9981
Mailing Address - Fax:540-508-2501
Practice Address - Street 1:251 COMMONWEALTH CT
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602-5347
Practice Address - Country:US
Practice Address - Phone:540-532-9981
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-07
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0401XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA30015320190002Medicaid