Individual ProviderNicole Marissa GiebenhainPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492(763) 520-7870PECOS EnrollmentBased on the most recent information from CMS, provider Nicole Marissa Giebenhain 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 ID1255858205Provider TypeIndividualFull NameGiebenhain, Nicole MarissaCredentialPTGenderFemaleSole ProprietorNoEnumeration Date8/29/2017Last Updated1/9/2020Contact InformationPractice LocationPractice Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492Phone(763) 520-7870Fax(763) 520-7580Mailing LocationMailing Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492Phone(763) 520-7870Fax(763) 520-7580Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense10697Minnesota