Individual ProviderRenee CarlsonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9404 Genesee Ave, Suite 310, La Jolla, CA 92037-1339(858) 455-1195PECOS EnrollmentBased on the most recent information from CMS, provider Renee 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 ID1164515177Provider TypeIndividualFull NameCarlson, ReneeCredentialP.T.GenderFemaleSole ProprietorNoEnumeration Date10/2/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address9404 Genesee Ave, Suite 310, La Jolla, CA 92037-1339Phone(858) 455-1195Fax(858) 455-7101Mailing LocationMailing Address9404 Genesee Ave, Suite 310, La Jolla, CA 92037-1339PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePT16834California