Individual ProviderCandace K PellaPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address500 Osborne Rd NE Ste 365, Fridley, MN 55432-2769(763) 236-2150PECOS EnrollmentBased on the most recent information from CMS, provider Candace K Pella 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 ID1518913359Provider TypeIndividualFull NamePella, Candace KCredentialPTGenderFemaleSole ProprietorNoEnumeration Date5/25/2006Last Updated4/26/2022Contact InformationPractice LocationPractice Address500 Osborne Rd NE Ste 365, Fridley, MN 55432-2769Phone(763) 236-2150Fax(637) 236-2155Mailing LocationMailing Address500 Osborne Rd NE Ste 365, Fridley, MN 55432-2769Phone(763) 236-2150Fax(637) 236-2155Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense4734MinnesotaProvider IdentifiersIDDescriptionIssuerID6405366DescriptionOtherIssuerMEDICAMinnesotaID134G1PEDescriptionOtherIssuerBLUE CROSS BLUE SHIELDMinnesotaID713523800DescriptionMedicaidIssuerUnlistedMinnesotaID125107DescriptionOtherIssuerUCAREMinnesotaID936131043346DescriptionOtherIssuerPREFERRED ONEMinnesotaIDHP49410DescriptionOtherIssuerHEALTH PARTNERSMinnesota