Individual ProviderKrista Lynn SiewertPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492(763) 520-7870(952) 512-5600PECOS EnrollmentBased on the most recent information from CMS, provider Krista Lynn Siewert 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 ID1538444062Provider TypeIndividualFull NameSiewert, Krista LynnCredentialD.P.TGenderFemaleSole ProprietorNoEnumeration Date10/16/2011Last Updated4/18/2022Contact InformationPractice LocationPractice Address9630 Grove Cir N Ste 200, Maple Grove, MN 55369-3492Phone(763) 520-7870Fax(763) 520-7580Mailing LocationMailing Address4200 Dahlberg Dr Ste 300, Golden Valley, MN 55422-4841Phone(952) 512-5600FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense9542MinnesotaCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense11801-024Wisconsin