Provider Demographics
NPI:1104491828
Name:THRIVE FAMILY CHIROPRACTIC, PC
Entity type:Organization
Organization Name:THRIVE FAMILY CHIROPRACTIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KILBY
Authorized Official - Middle Name:J
Authorized Official - Last Name:RECH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:605-850-9574
Mailing Address - Street 1:2800 JACKSON BLVD STE 2
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:SD
Mailing Address - Zip Code:57702-3477
Mailing Address - Country:US
Mailing Address - Phone:605-850-9574
Mailing Address - Fax:
Practice Address - Street 1:2800 JACKSON BLVD STE 2
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:SD
Practice Address - Zip Code:57702-3477
Practice Address - Country:US
Practice Address - Phone:605-850-9574
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty