Individual ProviderBeth Marie NicholsonPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address1122 W Divide Ave, Bismarck, ND 58501-1202(701) 258-5058(406) 585-1002PECOS EnrollmentBased on the most recent information from CMS, provider Beth Marie Nicholson 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 ID1912177411Provider TypeIndividualFull NameNicholson, Beth MarieCredentialDPTGenderFemaleSole ProprietorNoEnumeration Date3/11/2008Last Updated7/21/2022Contact InformationPractice LocationPractice Address1122 W Divide Ave, Bismarck, ND 58501-1202Phone(701) 258-5058Fax(701) 258-1041Mailing LocationMailing Address1122 W Divide Ave, Bismarck, ND 58501-1202Phone(406) 585-1002Fax(701) 258-1041Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense2076Montana