Individual ProviderKellen James CameronPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address7767 Elm Creek Blvd N Ste 160, Maple Grove, MN 55369-7078(763) 201-8191PECOS EnrollmentBased on the most recent information from CMS, provider Kellen James Cameron 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 ID1164144002Provider TypeIndividualFull NameCameron, Kellen JamesCredentialDPTGenderMaleSole ProprietorYesEnumeration Date9/16/2022Last Updated9/16/2022Contact InformationPractice LocationPractice Address7767 Elm Creek Blvd N Ste 160, Maple Grove, MN 55369-7078Phone(763) 201-8191Fax(763) 201-8192Mailing LocationMailing Address9645 Grove Cir N Ste 200, Maple Grove, MN 55369-2684Phone(763) 201-8191FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense12872Minnesota