Provider Demographics
NPI:1619484078
Name:THRIVE WITH VISION, PLLC
Entity Type:Organization
Organization Name:THRIVE WITH VISION, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DANISE
Authorized Official - Middle Name:JOANN
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:320-632-1950
Mailing Address - Street 1:118 E BROADWAY
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-3039
Mailing Address - Country:US
Mailing Address - Phone:320-632-1950
Mailing Address - Fax:
Practice Address - Street 1:118 E BROADWAY
Practice Address - Street 2:
Practice Address - City:LITTLE FALLS
Practice Address - State:MN
Practice Address - Zip Code:56345-3039
Practice Address - Country:US
Practice Address - Phone:320-632-1950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-08
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2873152WV0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WV0400XEye and Vision Services ProvidersOptometristVision TherapyGroup - Single Specialty