Provider Demographics
NPI:1508476060
Name:RISE THERAPY, PLLC
Entity Type:Organization
Organization Name:RISE THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMERLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS, OTR/L
Authorized Official - Phone:501-889-8383
Mailing Address - Street 1:PO BOX 425
Mailing Address - Street 2:
Mailing Address - City:BIGELOW
Mailing Address - State:AR
Mailing Address - Zip Code:72016-0425
Mailing Address - Country:US
Mailing Address - Phone:501-889-8383
Mailing Address - Fax:870-782-2803
Practice Address - Street 1:26 GAZO LN
Practice Address - Street 2:
Practice Address - City:BIGELOW
Practice Address - State:AR
Practice Address - Zip Code:72016-9638
Practice Address - Country:US
Practice Address - Phone:501-889-8383
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-08
Last Update Date:2020-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Single Specialty