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Organization
HULLABALOO PEDIATRIC THERAPY PLLC
Active
Organization
HULLABALOO PEDIATRIC THERAPY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KRISTI L. GRIMSLEY PT (OWNER)
(903) 391-8170
Entity
Organization
Contact information
Practice address
2035 CROCKETT RD, PALESTINE, TX 75801-5921
(903) 723-3602
(903) 731-9573
Mailing address
311 GLENWOOD DR., PALESTINE, TX 75801
(903) 391-8170
Taxonomy
Speciality
Code
Description
License number
State
261QH0700X
Hearing and Speech Clinic/Center
108561
TX
261QP2000X
Physical Therapy Clinic/Center
1099075
TX
261QR0400X
Rehabilitation Clinic/Center
Primary
1099075
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108015203
—
TX
05
—
201775804
—
TX
05
—
351507401
—
TX
05
—
351990201
—
TX
Enumeration date
05/11/2015
Last updated
01/15/2016
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