Individual ProviderByung-Chul ParkPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9827 Maple Grove Pkwy N, Maple Grove, MN 55369(952) 993-1460PECOS EnrollmentBased on the most recent information from CMS, provider Byung-Chul Park 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 ID1649527938Provider TypeIndividualFull NamePark, Byung-ChulCredentialDPTGenderMaleSole ProprietorYesEnumeration Date8/6/2012Last Updated8/28/2018Contact InformationPractice LocationPractice Address9827 Maple Grove Pkwy N, Maple Grove, MN 55369Phone(952) 993-1460FaxUnlisted FaxMailing LocationMailing Address9827 Maple Grove Pkwy N, Maple Grove, MN 55369-4491Phone(952) 993-1460FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense9145MinnesotaCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerMinnesota