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General NPI Number Information
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NPI Number | 1508476060
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Entity Type | Organization
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Legal Business Name | RISE THERAPY, PLLC
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Dates
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Enumeration Date | 08/08/2020
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Last Update Date | 08/08/2020
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Provider Practice Location Address
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Address Line | 26 GAZO LN
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City | BIGELOW
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State | AR
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Zip | 72016-9638
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Country | US
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Telephone | 501-889-8383
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 425
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City | BIGELOW
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State | AR
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Zip | 72016-0425
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Country | US
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Telephone | 501-889-8383
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Fax | 870-782-2803
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST
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Name | ALICIA HAMMERLE
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Credential | MS, OTR/L
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Telephone | 501-889-8383
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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