Provider Demographics
NPI:1457113482
Name:THRIVE FAMILY WELLNESS PLLC
Entity type:Organization
Organization Name:THRIVE FAMILY WELLNESS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:DUSTIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:WORTHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:501-471-9560
Mailing Address - Street 1:12400 CANTRELL RD STE 5
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72223-1706
Mailing Address - Country:US
Mailing Address - Phone:501-471-9560
Mailing Address - Fax:
Practice Address - Street 1:12400 CANTRELL RD STE 5
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72223-1706
Practice Address - Country:US
Practice Address - Phone:501-471-9560
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty