Provider Demographics
NPI:1902630403
Name:ALCHEMY SPORTS PERFORMANCE AND REHABILITATION
Entity type:Organization
Organization Name:ALCHEMY SPORTS PERFORMANCE AND REHABILITATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PALATUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:856-904-7177
Mailing Address - Street 1:4716 WHIPPLEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018-9088
Mailing Address - Country:US
Mailing Address - Phone:856-904-7177
Mailing Address - Fax:
Practice Address - Street 1:4716 WHIPPLEWOOD DR
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-9088
Practice Address - Country:US
Practice Address - Phone:856-904-7177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-27
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy