Healthcare Provider Details

I. General information

NPI: 1932033883
Provider Name (Legal Business Name): RISE PHYSIO AND PERFORMANCE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BOWLING LN
PELHAM AL
35124-4354
US

IV. Provider business mailing address

2308 RUSSET MEADOWS TER
BIRMINGHAM AL
35244-4632
US

V. Phone/Fax

Practice location:
  • Phone: 205-936-9391
  • Fax: 659-262-2270
Mailing address:
  • Phone: 205-936-9391
  • Fax: 659-262-2270

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NATHAN EAST
Title or Position: OWNER
Credential: PT, DPT, CSCS
Phone: 205-936-9391