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General NPI Number Information
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NPI Number | 1780217802
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Entity Type | Organization
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Legal Business Name | RISE PELVIC THERAPY & WELLNESS, LLC
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Dates
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Enumeration Date | 02/17/2020
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Last Update Date | 11/18/2020
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Provider Practice Location Address
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Address Line | 1380 S CASTLE DOME AVE STE 104
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City | YUMA
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State | AZ
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Zip | 85365-2024
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Country | US
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Telephone | 612-963-2147
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Fax |
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Provider Business Mailing Address
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Address Line | 2911 S RAINBOW AVE
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City | YUMA
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State | AZ
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Zip | 85365-3535
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Country | US
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Telephone | 612-963-2147
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | LAURI STUMPH
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Credential | O.T.
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Telephone | 928-605-7070
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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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