Provider Demographics
NPI:1841876786
Name:THRIVE AT HOME MOBILE PHYSICAL THERAPY
Entity type:Organization
Organization Name:THRIVE AT HOME MOBILE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:CHERI
Authorized Official - Middle Name:
Authorized Official - Last Name:FLANAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:321-343-2282
Mailing Address - Street 1:1110 LOVE CT NW
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-9489
Mailing Address - Country:US
Mailing Address - Phone:321-343-2282
Mailing Address - Fax:
Practice Address - Street 1:1110 LOVE CT NW
Practice Address - Street 2:
Practice Address - City:PALM BAY
Practice Address - State:FL
Practice Address - Zip Code:32907-9489
Practice Address - Country:US
Practice Address - Phone:321-343-2282
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy