Healthcare Provider Details

I. General information

NPI: 1407778673
Provider Name (Legal Business Name): RISE PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2026
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

765 E 100 N
PAYSON UT
84651-2373
US

IV. Provider business mailing address

28 W HACKBERRY RD
VINEYARD UT
84059-6538
US

V. Phone/Fax

Practice location:
  • Phone: 801-856-9577
  • Fax: 801-316-0122
Mailing address:
  • Phone: 801-856-9577
  • Fax: 801-316-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: KYLE CHARLES ANDERSON
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 801-856-9577