Provider Demographics
NPI:1053987917
Name:THRIVE INTEGRATIVE HEALTH & PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:THRIVE INTEGRATIVE HEALTH & PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:B
Authorized Official - Last Name:PORTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-301-4447
Mailing Address - Street 1:2994 BARNEY RD
Mailing Address - Street 2:
Mailing Address - City:TOUCHET
Mailing Address - State:WA
Mailing Address - Zip Code:99360-9681
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2994 BARNEY RD
Practice Address - Street 2:
Practice Address - City:TOUCHET
Practice Address - State:WA
Practice Address - Zip Code:99360-9681
Practice Address - Country:US
Practice Address - Phone:509-301-4447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-01
Last Update Date:2021-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty