Provider Demographics
NPI:1255958930
Name:RISE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:RISE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:POOJABEN
Authorized Official - Middle Name:SEAN
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:540-588-5633
Mailing Address - Street 1:3710 EXCHANGE GLENWOOD PL APT 346
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27612-4853
Mailing Address - Country:US
Mailing Address - Phone:540-588-5633
Mailing Address - Fax:
Practice Address - Street 1:3710 EXCHANGE GLENWOOD PL APT 346
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27612-4853
Practice Address - Country:US
Practice Address - Phone:540-588-5633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy