Individual ProviderJonathan Charles StaigerPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address7700 Highway 65 NE, Spring Lake Park, MN 55432-2832(763) 784-3155PECOS EnrollmentBased on the most recent information from CMS, provider Jonathan Charles Staiger 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 ID1972700961Provider TypeIndividualFull NameStaiger, Jonathan CharlesTitleMr.CredentialP.T.GenderMaleSole ProprietorNoEnumeration Date7/2/2007Last Updated10/21/2008Contact InformationPractice LocationPractice Address7700 Highway 65 NE, Spring Lake Park, MN 55432-2832Phone(763) 784-3155Fax(763) 784-2352Mailing LocationMailing Address7700 Highway 65 NE, Spring Lake Park, MN 55432-2832Phone(763) 784-3155Fax(763) 784-2352Provider TaxonomiesCodeDescriptionLicenseCode225100000XPrimaryDescriptionPhysical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense8038MinnesotaProvider IdentifiersIDDescriptionIssuerID300953100DescriptionMedicaidIssuerUnlistedMinnesota