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NPI Code Detail

MEDICARE: RISE UP PEDIATRIC THERAPY LLC

MEDICARE: RISE UP PEDIATRIC THERAPY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225XF0002XFeeding, Eating & Swallowing Occupational Therapist
2225XP0200XPediatric Occupational Therapist

General Provider Information

NPI Number : 1982467924
Entity Type Code : Organization
Provider Name (Legal Business Name) : RISE UP PEDIATRIC THERAPY LLC
Provider Business Mailing Address
First Line : 25060 CULTUS LN
Second Line :
City : BEND
State : OR
Zip : 97701-9638
Country : US
Telephone Number : 207-807-7147
Fax Number :
Provider Business Practice Location Address
First Line : 25060 CULTUS LN
Second Line :
City : BEND
State : OR
Zip : 97701-9638
Country : US
Telephone Number : 207-807-7147
Fax Number :
Authorized Official
Title or Position : OCCUPATIONAL THERAPIST
Name : SARAH LINDEN
Credential : MOT, OTR/L
Telephone Number : 207-807-7147
Provider Enumeration Date : 02/01/2024
Last Update Date : 02/07/2024

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Directions to “RISE UP PEDIATRIC THERAPY LLC ” Practice Location

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