Individual ProviderStephanie Ann ThiedePhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address15800 95th Ave N, Maple Grove, MN 55369-4400(952) 993-1440PECOS EnrollmentBased on the most recent information from CMS, provider Stephanie Ann Thiede 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 ID1083704431Provider TypeIndividualFull NameThiede, Stephanie AnnGenderFemaleSole ProprietorNoEnumeration Date10/14/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address15800 95th Ave N, Maple Grove, MN 55369-4400Phone(952) 993-1440FaxUnlisted FaxMailing LocationMailing Address15800 95th Ave N, Maple Grove, MN 55369-4400PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense7613Minnesota