Provider Demographics
NPI:1548438955
Name:THRIVE PHYSICAL THERAPY AND FITNESS LLC
Entity type:Organization
Organization Name:THRIVE PHYSICAL THERAPY AND FITNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:O'NEAL
Authorized Official - Last Name:MULLER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:229-221-0286
Mailing Address - Street 1:814 GORDON AVE
Mailing Address - Street 2:
Mailing Address - City:THOMASVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:31792-6611
Mailing Address - Country:US
Mailing Address - Phone:229-228-9019
Mailing Address - Fax:229-228-6066
Practice Address - Street 1:814 GORDON AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:GA
Practice Address - Zip Code:31792-6611
Practice Address - Country:US
Practice Address - Phone:229-228-9019
Practice Address - Fax:229-228-6066
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2010-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty