Provider Demographics
NPI:1528455532
Name:FRAIS, VIRGINIA RENEE (PTA)
Entity type:Individual
Prefix:MS
First Name:VIRGINIA
Middle Name:RENEE
Last Name:FRAIS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1835 BELMORE RD
Mailing Address - Street 2:
Mailing Address - City:EAST CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44112-4301
Mailing Address - Country:US
Mailing Address - Phone:216-628-3600
Mailing Address - Fax:216-451-4805
Practice Address - Street 1:1835 BELMORE RD
Practice Address - Street 2:
Practice Address - City:EAST CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44112-4301
Practice Address - Country:US
Practice Address - Phone:216-628-3600
Practice Address - Fax:216-451-4805
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-17
Last Update Date:2015-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03291225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant