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General NPI Number Information
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NPI Number | 1427216563
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Entity Type | Organization
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Legal Business Name | PIT SHOP REHAB, LLC
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Dates
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Enumeration Date | 05/27/2008
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 226 N TRAVIS AVE
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City | CLEVELAND
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State | TX
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Zip | 77327-4198
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Country | US
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Telephone | 281-592-3008
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Fax | 281-592-3003
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Provider Business Mailing Address
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Address Line | 226 N TRAVIS AVE
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City | CLEVELAND
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State | TX
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Zip | 77327-4198
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Country | US
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Telephone | 281-592-3008
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Fax | 281-592-3003
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. SHERRY L HALLMAN
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Credential |
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Telephone | 281-592-3008
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 657250000
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License Number State | TX
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