Provider Demographics
NPI:1386832699
Name:PIT STOP REHAB,LLC
Entity Type:Organization
Organization Name:PIT STOP REHAB,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:J
Authorized Official - Last Name:KELLY
Authorized Official - Suffix:
Authorized Official - Credentials:PT,MS
Authorized Official - Phone:281-592-3008
Mailing Address - Street 1:226 N TRAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4198
Mailing Address - Country:US
Mailing Address - Phone:281-592-3008
Mailing Address - Fax:281-592-3003
Practice Address - Street 1:226 N TRAVIS AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4198
Practice Address - Country:US
Practice Address - Phone:281-592-3008
Practice Address - Fax:281-592-3003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy