Provider Demographics
NPI:1114650926
Name:THRIVE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:THRIVE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATASHA
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:MARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-830-0969
Mailing Address - Street 1:29241 SOUTH DAKOTA HIGHWAY 47
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:SD
Mailing Address - Zip Code:57523
Mailing Address - Country:US
Mailing Address - Phone:605-830-0969
Mailing Address - Fax:
Practice Address - Street 1:802 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BURKE
Practice Address - State:SD
Practice Address - Zip Code:57523
Practice Address - Country:US
Practice Address - Phone:605-775-2003
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty