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General NPI Number Information
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NPI Number | 1144143728
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Entity Type | Organization
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Legal Business Name | ROOT & RISE PHYSIOTHERAPY
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Dates
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Enumeration Date | 07/31/2026
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Last Update Date | 07/31/2026
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Provider Practice Location Address
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Address Line | 380 MORRIS ST STE L
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City | SEBASTOPOL
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State | CA
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Zip | 95472-3870
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Country | US
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Telephone | 707-217-9157
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Fax | 888-308-0989
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Provider Business Mailing Address
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Address Line | 5150 WIKIUP BRIDGE WAY
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City | SANTA ROSA
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State | CA
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Zip | 95404-1122
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Country | US
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Telephone | 707-217-9157
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Fax | 888-308-0989
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. CHRISTINA MARIE LEISEN
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Credential | PT, DPT
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Telephone | 707-217-9157
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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