Provider Demographics
NPI:1649647710
Name:THRIVE CHIROPRACTIC, LLC
Entity type:Organization
Organization Name:THRIVE CHIROPRACTIC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMITT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:989-934-0770
Mailing Address - Street 1:1825 SW WHITE BIRCH CIR
Mailing Address - Street 2:UNIT 16
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023-7205
Mailing Address - Country:US
Mailing Address - Phone:989-934-0770
Mailing Address - Fax:
Practice Address - Street 1:85 PAINE ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:BONDURANT
Practice Address - State:IA
Practice Address - Zip Code:50035-1154
Practice Address - Country:US
Practice Address - Phone:989-934-0770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-25
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA079049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty