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General NPI Number Information
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NPI Number | 1922812585
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Entity Type | Organization
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Legal Business Name | RAISE THE BAR PHYSICAL THERAPY AND WELLNESS
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 5820 ROAD 92 STE 206
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City | PASCO
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State | WA
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Zip | 99301-2678
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Country | US
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Telephone | 509-492-2545
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Fax |
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Provider Business Mailing Address
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Address Line | 6509 ROAD 84 PL
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City | PASCO
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State | WA
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Zip | 99301-7706
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Country | US
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Telephone | 509-492-2545
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST/ OWNER
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Name | DR. DESIRAE LYALL
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Credential | DPT
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Telephone | 509-492-2545
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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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