Individual ProviderReilly PetersonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address7241 University Ave NE, Fridley, MN 55432-3134(763) 450-9400PECOS EnrollmentBased on the most recent information from CMS, provider Reilly Peterson 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 ID1194417311Provider TypeIndividualFull NamePeterson, ReillyCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date5/25/2023Last Updated5/25/2023Contact InformationPractice LocationPractice Address7241 University Ave NE, Fridley, MN 55432-3134Phone(763) 450-9400FaxUnlisted FaxMailing LocationMailing Address7241 University Ave NE, Fridley, MN 55432-3134PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense13055Minnesota