Provider Demographics
NPI:1023350642
Name:THRIVE FAMILY CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:THRIVE FAMILY CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRISTA
Authorized Official - Middle Name:M
Authorized Official - Last Name:BRINGA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:262-689-4203
Mailing Address - Street 1:N88W16644 APPLETON AVE
Mailing Address - Street 2:
Mailing Address - City:MENOMONEE FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:53051-2853
Mailing Address - Country:US
Mailing Address - Phone:262-255-6250
Mailing Address - Fax:262-255-4844
Practice Address - Street 1:N88W16644 APPLETON AVE
Practice Address - Street 2:
Practice Address - City:MENOMONEE FALLS
Practice Address - State:WI
Practice Address - Zip Code:53051-2853
Practice Address - Country:US
Practice Address - Phone:262-255-6250
Practice Address - Fax:262-255-4844
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-21
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4896-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty