Provider Demographics
NPI:1841615838
Name:FRALIN BIOMEDICAL RESEARCH INSTITUTE @ VTC NEUROMOTOR RESEARCH CLINIC
Entity Type:Organization
Organization Name:FRALIN BIOMEDICAL RESEARCH INSTITUTE @ VTC NEUROMOTOR RESEARCH CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:DELUCA
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:540-526-2202
Mailing Address - Street 1:2 RIVERSIDE CIR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24016-4950
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2 RIVERSIDE CIR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-4950
Practice Address - Country:US
Practice Address - Phone:540-526-2202
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRGINIA POLYTECHNIC INSITITUTE AND STATE UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-02-27
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation