Individual ProviderPatrick David CarlsonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address480 Osborne Rd NE, #280, Fridley, MN 55432-2773(763) 784-3155(763) 422-1029PECOS EnrollmentBased on the most recent information from CMS, provider Patrick David 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 12:57 PM.Profile DetailsProvider ID1043646029Provider TypeIndividualFull NameCarlson, Patrick DavidTitleDr.CredentialD.P.TGenderMaleSole ProprietorNoEnumeration Date9/23/2013Last Updated9/23/2013Contact InformationPractice LocationPractice Address480 Osborne Rd NE, #280, Fridley, MN 55432-2773Phone(763) 784-3155FaxUnlisted FaxMailing LocationMailing Address12143 Lily St NW, Coon Rapids, MN 55433-1784Phone(763) 422-1029FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense9318Minnesota