Individual ProviderKelly Marie DiehlPhysical 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 Kelly Marie Diehl 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 ID1649683004Provider TypeIndividualFull NameDiehl, Kelly MarieCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date6/3/2014Last Updated8/6/2021Contact 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 ProvidersLicense12657WisconsinCode225100000XDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicensePTP-PT-LIC-7501Montana