Provider Demographics
NPI:1982463220
Name:THRIVE PELVIC WELLNESS
Entity type:Organization
Organization Name:THRIVE PELVIC WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:FREGEAU
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:802-735-7944
Mailing Address - Street 1:173 AIKEY LN
Mailing Address - Street 2:
Mailing Address - City:COLCHESTER
Mailing Address - State:VT
Mailing Address - Zip Code:05446-4470
Mailing Address - Country:US
Mailing Address - Phone:802-735-7944
Mailing Address - Fax:
Practice Address - Street 1:1 MILL ST STE 200
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-1535
Practice Address - Country:US
Practice Address - Phone:802-391-4107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty