Individual
BETHANY DIAMOND CARNEFIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0002
(507) 284-2511
Mailing address
PO BOX 860912, PROVIDER ENROLLMENT - RST, ROCHESTER, MN 55486-0912
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
13751
MN
225100000X
Physical Therapist
PT60843631
WA
2255A2300X
Athletic Trainer
004340
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13751
PHYSICAL THERAPY BOARD OF MINNESOTA
MN
05
—
2098539
—
WA
01
—
PT60843631
PHYSICAL THERAPY BOARD OF WASHINGTON
WA
Enumeration date
03/25/2017
Last updated
04/22/2025
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