Stuart William Russell | Elk Grove, CA • PECOS Search

Stuart William Russell

Chiropractor

Chiropractic Providers

9108 Laguna Main St Ste 1a, Elk Grove, CA 95758-7450

(916) 691-9500 (916) 217-0906

PECOS Enrollment

Based on the most recent information from CMS, provider Stuart William Russell 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 2 days ago.

Profile Details

Provider ID
1639343841
Provider Type
Individual
Full Name
Russell, Stuart William
Credential
D.C.

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/17/2008
Last Updated
4/17/2008

Contact Information

Practice Location

9108 Laguna Main St Ste 1a, Elk Grove, CA 95758-7450

(916) 691-9503

Mailing Location

7210 Novato Ct, Elk Grove, CA 95757-3462

(916) 691-9503

Provider Taxonomies

Code	Description	License
Code 111N00000X Primary	Description Chiropractor Chiropractic Providers	License 14218 California
Code 111N00000X	Description Chiropractor Chiropractic Providers	License 1635 Oregon