Healthcare Provider Details

I. General information

NPI: 1386567733
Provider Name (Legal Business Name): ROOTED PHYSICAL THERAPY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 MOUNTAIN LEDGE STE 3
WILTON NY
12831-2588
US

IV. Provider business mailing address

6 MOUNTAIN LEDGE STE 3
WILTON NY
12831-2588
US

V. Phone/Fax

Practice location:
  • Phone: 978-353-9191
  • Fax:
Mailing address:
  • Phone: 978-353-9191
  • Fax:

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: DR. KYLE AARON PEARSON
Title or Position: OWNER/PHYSICAL THERAPIST
Credential: DPT
Phone: 978-353-9191