| Organization Name: | HULLABALOO PEDIATRIC THERAPY PLLC |
| NPI Number: | 1073991964 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KRISTI L. GRIMSLEY (OWNER) |
| Mailing Address: | 2035 Crockett Rd Palestine |
| State: | TX US |
| Postal Code: | 758015921 |
| Phone Number: | 9037233602 |
| Fax Number: | 9037319573 |
| NPI Enumeration Date: | 05/11/2015 |
| NPI Last Update Date: | 01/15/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | 1099075 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |