=====================================================
General NPI Number Information
=====================================================
NPI Number | 1245034289
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RISE ABOVE POTS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/01/2025
-----------------------------------------------------
Last Update Date | 04/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 21 ALCOTT DR
-----------------------------------------------------
City | NORTHBOROUGH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01532-2703
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-380-1873
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11 APEX DR
-----------------------------------------------------
City | MARLBOROUGH
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01752-1858
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/CEO/PHYSICAL THERAPIST
-----------------------------------------------------
Name | ASHLEY SOUGHLEY
-----------------------------------------------------
Credential | PT, DPT, NCS
-----------------------------------------------------
Telephone | 508-380-1873
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2251N0400X
-----------------------------------------------------
Taxonomy Name | Neurology Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------