Provider Demographics
NPI:1386867844
Name:BCSP HOLDINGS
Entity Type:Organization
Organization Name:BCSP HOLDINGS
Other - Org Name:TRAUMA AND PAIN MANAGEMENT INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHULZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:612-723-8870
Mailing Address - Street 1:316 4TH ST NE
Mailing Address - Street 2:
Mailing Address - City:OSSEO
Mailing Address - State:MN
Mailing Address - Zip Code:55369-1118
Mailing Address - Country:US
Mailing Address - Phone:612-723-8870
Mailing Address - Fax:
Practice Address - Street 1:316 4TH ST NE
Practice Address - Street 2:
Practice Address - City:OSSEO
Practice Address - State:MN
Practice Address - Zip Code:55369-1118
Practice Address - Country:US
Practice Address - Phone:612-723-8870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN708111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty