Individual ProviderAlexander Lawrence KuczwarskyjPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492(763) 520-7870PECOS EnrollmentBased on the most recent information from CMS, provider Alexander Lawrence Kuczwarskyj does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1437718558Provider TypeIndividualFull NameKuczwarskyj, Alexander LawrenceCredentialPT, DPTGenderMaleSole ProprietorNoEnumeration Date6/12/2019Last Updated9/3/2019Contact InformationPractice LocationPractice Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492Phone(763) 520-7870Fax(763) 520-7580Mailing LocationMailing Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492Phone(763) 520-7870Fax(763) 520-7580Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense11474MinnesotaCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense9722South Carolina