Provider Demographics
NPI:1013399534
Name:RISE REHABILITATION, LLC
Entity Type:Organization
Organization Name:RISE REHABILITATION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING/MEMBER, PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:ST CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:843-697-9403
Mailing Address - Street 1:623 ADLUH ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-4401
Mailing Address - Country:US
Mailing Address - Phone:843-697-9493
Mailing Address - Fax:843-388-7475
Practice Address - Street 1:623 ADLUH ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-4401
Practice Address - Country:US
Practice Address - Phone:843-697-9493
Practice Address - Fax:843-388-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-20
Last Update Date:2015-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6210261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy