Provider Demographics
NPI:1184306359
Name:ROOT TO RISE THERAPY LLC
Entity type:Organization
Organization Name:ROOT TO RISE THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BARRETT
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:215-900-0216
Mailing Address - Street 1:606 F AVE
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-1226
Mailing Address - Country:US
Mailing Address - Phone:215-900-0216
Mailing Address - Fax:
Practice Address - Street 1:212 FIR ST
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-2627
Practice Address - Country:US
Practice Address - Phone:541-240-8042
Practice Address - Fax:541-507-6094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty