Provider Demographics
NPI:1427579689
Name:THRIVE FAMILY CHIROPRACTIC PLLC
Entity Type:Organization
Organization Name:THRIVE FAMILY CHIROPRACTIC PLLC
Other - Org Name:THRIVE FAMILY CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:COOLEDGE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:207-251-2932
Mailing Address - Street 1:383 CENTRAL AVE STE 264
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NH
Mailing Address - Zip Code:03820-6420
Mailing Address - Country:US
Mailing Address - Phone:207-251-2932
Mailing Address - Fax:
Practice Address - Street 1:383 CENTRAL AVE STE 264
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NH
Practice Address - Zip Code:03820-6420
Practice Address - Country:US
Practice Address - Phone:207-251-2932
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1002111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty