Individual ProviderJeffrey James CarlsonSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2104 Northdale Blvd NW, Suite 100, Coon Rapids, MN 55433-3005(763) 755-5495(763) 323-1732PECOS EnrollmentBased on the most recent information from CMS, provider Jeffrey James Carlson 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 9:15 AM.Profile DetailsProvider ID1003987132Provider TypeIndividualFull NameCarlson, Jeffrey JamesCredentialM ED, ATCGenderMaleSole ProprietorNoEnumeration Date11/12/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address2104 Northdale Blvd NW, Suite 100, Coon Rapids, MN 55433-3005Phone(763) 755-5495FaxUnlisted FaxMailing LocationMailing Address3777 114th Ln NW, Coon Rapids, MN 55433-2607Phone(763) 323-1732FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2255A2300XPrimaryDescriptionSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted Issuer