Provider Demographics
NPI:1407960818
Name:FRACALOSSI, JOAN M (MEMMGR-R&J RAMPS LLC)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:FRACALOSSI
Suffix:
Gender:F
Credentials:MEMMGR-R&J RAMPS LLC
Other - Prefix:
Other - First Name:RONALD
Other - Middle Name:J
Other - Last Name:FRACALOSSI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MEM-R&J RAMPS LLC
Mailing Address - Street 1:10196 STONEYBROOK CT SE
Mailing Address - Street 2:
Mailing Address - City:LELAND
Mailing Address - State:NC
Mailing Address - Zip Code:28451-8474
Mailing Address - Country:US
Mailing Address - Phone:910-383-2560
Mailing Address - Fax:866-294-2371
Practice Address - Street 1:10196 STONEYBROOK CT SE
Practice Address - Street 2:
Practice Address - City:LELAND
Practice Address - State:NC
Practice Address - Zip Code:28451-8474
Practice Address - Country:US
Practice Address - Phone:910-383-2560
Practice Address - Fax:866-294-2371
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications