Provider Demographics
NPI:1649469313
Name:REHABILITATION AND NEUROLOGY CONSULTANTS, PC
Entity type:Organization
Organization Name:REHABILITATION AND NEUROLOGY CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:M
Authorized Official - Last Name:STELMACK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:540-776-6262
Mailing Address - Street 1:PO BOX 4685
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-0685
Mailing Address - Country:US
Mailing Address - Phone:540-776-6262
Mailing Address - Fax:540-982-3959
Practice Address - Street 1:1215 CORPORATE CIR SW
Practice Address - Street 2:SUITE 201
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-1400
Practice Address - Country:US
Practice Address - Phone:540-776-6262
Practice Address - Fax:540-776-6266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0102036910208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAE48156Medicare UPIN
VA00X562R01Medicare PIN
VAC10347Medicare PIN