Individual ProviderBethany Lynne PetersonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1836 South Ave, La Crosse, WI 54601-5429(608) 782-7300PECOS EnrollmentBased on the most recent information from CMS, provider Bethany Lynne 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 ID1316304033Provider TypeIndividualFull NamePeterson, Bethany LynneCredentialPTGenderFemaleSole ProprietorNoEnumeration Date1/26/2016Last Updated1/26/2016Contact InformationPractice LocationPractice Address1836 South Ave, La Crosse, WI 54601-5429Phone(608) 782-7300FaxUnlisted FaxMailing LocationMailing Address1836 South Ave, La Crosse, WI 54601-5429Phone(608) 782-7300FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense12514Wisconsin