Individual ProviderStacy FullerChiropractorChiropractic ProvidersPractice Address300 W 80th Pl Ste A, Merrillville, IN 46410(219) 588-3476PECOS EnrollmentBased on the most recent information from CMS, provider Stacy Fuller 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 2 days ago.Profile DetailsProvider ID1376909333Provider TypeIndividualFull NameFuller, StacyCredentialDCGenderFemaleSole ProprietorNoEnumeration Date1/6/2016Last Updated4/11/2019Contact InformationPractice LocationPractice Address300 W 80th Pl Ste A, Merrillville, IN 46410Phone(219) 588-3476FaxUnlisted FaxMailing LocationMailing Address2406 Nottingham Dr, Valparaiso, IN 46383-9181Phone(219) 588-3476FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode111N00000XPrimaryDescriptionChiropractorChiropractic ProvidersLicense08002869AIndiana