Individual ProviderJessica L KingPhysical 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 Jessica L King 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 ID1609847862Provider TypeIndividualFull NameKing, Jessica LCredentialP.T.GenderFemaleSole ProprietorNoEnumeration Date1/27/2006Last Updated4/11/2016Contact 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 ProvidersLicense10243WisconsinCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense7361MinnesotaProvider IdentifiersIDDescriptionIssuerID046663800DescriptionMedicaidIssuerUnlistedMinnesota