Organization
THRYVE HEALING AND PERFORMANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DYLAN CHURCH ATC (CO-OWNER/ATHLETIC TRAINER)
(908) 239-9392
Entity
Organization
Contact information
Practice address
734 GRAND AVE, RIDGEFIELD, NJ 07657-1041
(732) 962-6056
Mailing address
415 STATE ROUTE 34 STE 108, COLTS NECK, NJ 07722-2523
(732) 962-6056
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
—
—
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
05/09/2022
Last updated
05/09/2022
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