Organization
THRIVE PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMANTHA NOVOTNY DPT (PHYSICAL THERAPIST)
(605) 840-9802
Entity
Organization
Contact information
Practice address
510 W 14TH ST, WINNER, SD 57580-2514
(605) 840-9802
Mailing address
510 W 14TH ST, WINNER, SD 57580-2514
(605) 840-9802
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
252Y00000X
Early Intervention Provider Agency
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033599543
—
SD
Enumeration date
05/28/2022
Last updated
05/28/2022
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