Provider Demographics
NPI:1417780222
Name:RALLY TO RISE PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:RALLY TO RISE PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MORGAN
Authorized Official - Middle Name:JESSE
Authorized Official - Last Name:RICKS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:208-715-8504
Mailing Address - Street 1:939 S 25TH E STE 104
Mailing Address - Street 2:
Mailing Address - City:AMMON
Mailing Address - State:ID
Mailing Address - Zip Code:83406-5735
Mailing Address - Country:US
Mailing Address - Phone:208-715-8504
Mailing Address - Fax:208-715-8505
Practice Address - Street 1:939 S 25TH E STE 104
Practice Address - Street 2:
Practice Address - City:AMMON
Practice Address - State:ID
Practice Address - Zip Code:83406-5735
Practice Address - Country:US
Practice Address - Phone:208-201-2757
Practice Address - Fax:208-715-8505
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy