Individual ProviderJessica DworakPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address550 Osborne Rd NE, Fridley, MN 55432-2718(763) 236-5000(507) 951-6720PECOS EnrollmentBased on the most recent information from CMS, provider Jessica Dworak 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 ID1871201129Provider TypeIndividualFull NameDworak, JessicaCredentialPT, DPTGenderFemaleSole ProprietorNoEnumeration Date11/7/2022Last Updated11/7/2022Contact InformationPractice LocationPractice Address550 Osborne Rd NE, Fridley, MN 55432-2718Phone(763) 236-5000FaxUnlisted FaxMailing LocationMailing Address8562 Carson Ct, Inver Grove Heights, MN 55076-5153Phone(507) 951-6720FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense11772Minnesota