Provider Demographics
NPI:1083022255
Name:THRIVE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:THRIVE CHIROPRACTIC LLC
Other - Org Name:THRIVE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:LEIGH-CLEARY
Authorized Official - Last Name:DONGARRA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:410-490-4976
Mailing Address - Street 1:34 THEO LN
Mailing Address - Street 2:
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-2750
Mailing Address - Country:US
Mailing Address - Phone:410-490-4976
Mailing Address - Fax:
Practice Address - Street 1:34 THEO LN
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-2750
Practice Address - Country:US
Practice Address - Phone:410-490-4976
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-31
Last Update Date:2014-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS03657261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service