Organization
PIT STOP REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN J KELLY PT (PT)
(281) 592-3008
Entity
Organization
Contact information
Practice address
119 N COLLEGE AVE, CLEVELAND, TX 77327
(281) 592-3008
(281) 592-3003
Mailing address
119 N COLLEGE AVE, CLEVELAND, TX 77327-4005
(281) 592-3008
(281) 592-3003
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
657250000
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0055MR
BLUE CROSS BLUE SHIELD
TX
05
—
177741901
—
TX
Enumeration date
02/11/2008
Last updated
05/18/2018
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