MEDICARE: MS. VIRGINIA RENEE FRAIS PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	03291	OH

General Provider Information

NPI Number	:	1528455532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VIRGINIA RENEE FRAIS PTA

Provider Business Mailing Address
First Line	:	1835 BELMORE RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-4301
Country	:	US
Telephone Number	:	216-628-3600
Fax Number	:	216-451-4805

Provider Business Practice Location Address
First Line	:	1835 BELMORE RD
Second Line	:
City	:	EAST CLEVELAND
State	:	OH
Zip	:	44112-4301
Country	:	US
Telephone Number	:	216-628-3600
Fax Number	:	216-451-4805

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/17/2015
Last Update Date	:	04/17/2015

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