Provider Demographics
NPI:1932503760
Name:THRIVE WELLNESS AND REHAB, LLC
Entity Type:Organization
Organization Name:THRIVE WELLNESS AND REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNNDY
Authorized Official - Middle Name:DION
Authorized Official - Last Name:THAUBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:803-339-9339
Mailing Address - Street 1:5175 SUNSET BLVD
Mailing Address - Street 2:SUITE K
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-7319
Mailing Address - Country:US
Mailing Address - Phone:803-339-9339
Mailing Address - Fax:
Practice Address - Street 1:5175 SUNSET BLVD
Practice Address - Street 2:SUITE K
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-7319
Practice Address - Country:US
Practice Address - Phone:803-339-9339
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty