Provider Demographics
NPI:1457970949
Name:RISE AND THRIVE MOBILITY CONSULTANTS
Entity Type:Organization
Organization Name:RISE AND THRIVE MOBILITY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST, SOLE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:N
Authorized Official - Last Name:DIEDRICH
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:520-955-3523
Mailing Address - Street 1:2902 E EASTLAND ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85716-5761
Mailing Address - Country:US
Mailing Address - Phone:520-955-3523
Mailing Address - Fax:
Practice Address - Street 1:2902 E EASTLAND ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85716-5761
Practice Address - Country:US
Practice Address - Phone:520-955-3523
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-14
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No261QA0900XAmbulatory Health Care FacilitiesClinic/CenterAmputee