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General NPI Number Information
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NPI Number | 1790699783
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Entity Type | Organization
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Legal Business Name | RISE PEDIATRIC THERAPY CO
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Dates
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Enumeration Date | 09/29/2026
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 451 E COUNTY ROAD 56
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City | FORT COLLINS
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State | CO
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Zip | 80524-9523
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Country | US
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Telephone | 970-222-4620
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Fax |
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Provider Business Mailing Address
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Address Line | 451 E COUNTY ROAD 56
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City | FORT COLLINS
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State | CO
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Zip | 80524-9523
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Country | US
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Telephone | 970-222-4620
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | HEATHER N VAUGHN
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Credential | MS OTRL
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Telephone | 970-222-4620
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225XP0200X
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Taxonomy Name | Pediatric Occupational Therapist
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License Number |
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License Number State | NULL
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