Look up the most recent NPI and PECOS records

Big Brain Concussion Recovery & Chiropractic Pa

Chiropractor

Chiropractic Providers

3313 Republic Ave., St. Louis Park, MN 55426

PECOS Enrollment

Based on the most recent information from CMS, provider Big Brain Concussion Recovery & Chiropractic Pa does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records today at 10:51 AM.

Profile Details

Provider ID
1821657545
Provider Type
Organization
Full Name
Big Brain Concussion Recovery & Chiropractic Pa

Subpart
No
Enumeration Date
6/6/2019
Last Updated
9/3/2019

Contact Information

Practice Location

3313 Republic Ave., St. Louis Park, MN 55426

(612) 374-3392

(612) 374-3477

Mailing Location

3313 Republic Ave., St. Louis Park, MN 55426

(612) 374-3392

(612) 374-3477

Authorized Official

Stussy, David Lloyd (Owner/Doctor)

(612) 374-3392

Provider Taxonomies

Code	Description	License
Code 111N00000X Primary	Description Chiropractor Chiropractic Providers	License Unlisted Issuer

Big Brain Concussion Recovery & Chiropractic Pa

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Authorized Official

Provider Taxonomies

Code

Description

License

Code

Description

License

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