Provider Demographics
NPI:1982946646
Name:THRIVE THERAPY CENTER
Entity type:Organization
Organization Name:THRIVE THERAPY CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:
Authorized Official - Last Name:LOMANTO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:732-866-1903
Mailing Address - Street 1:PO BOX 297
Mailing Address - Street 2:
Mailing Address - City:MARLBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:07746-0297
Mailing Address - Country:US
Mailing Address - Phone:732-866-1903
Mailing Address - Fax:
Practice Address - Street 1:30 N MAIN ST
Practice Address - Street 2:
Practice Address - City:MARLBORO
Practice Address - State:NJ
Practice Address - Zip Code:07746-1429
Practice Address - Country:US
Practice Address - Phone:732-866-1903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-20
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty