Organization
THRIVE PEDIATRIC THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLEY JOHANNES PT, DPT (OWNER)
(704) 785-5152
Entity
Organization
Contact information
Practice address
139 DEWFIELD LN, BOILING SPRINGS, SC 29316-6167
(704) 785-5152
Mailing address
139 DEWFIELD LN, BOILING SPRINGS, SC 29316-6167
(704) 785-5152
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
11/25/2019
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