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General NPI Number Information
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NPI Number | 1366062127
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Entity Type | Organization
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Legal Business Name | RISE ABOVE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 04/22/2020
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 1655 CANE BAY BLVD STE B
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City | SUMMERVILLE
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State | SC
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Zip | 29486-2397
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Country | US
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Telephone | 843-719-7473
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Fax | 843-279-3251
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Provider Business Mailing Address
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Address Line | 1655 CANE BAY BLVD STE B
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City | SUMMERVILLE
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State | SC
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Zip | 29486-2397
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Country | US
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Telephone | 843-719-7473
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Fax | 843-279-3251
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Authorized Official
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Title or Position | DIR OF OPERATIONS
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Name | STACY RYDBOM
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Credential | PTA
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Telephone | 724-413-0297
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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