Individual
CRAIG MICHAEL HENNEBERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S., P.T., D.P.T.
Contact information
Practice address
2507 E 27TH AVE, SPOKANE, WA 99223-4908
(509) 456-6917
(509) 456-5902
Mailing address
2507 E 27TH AVE, SPOKANE, WA 99223-4908
(509) 456-6917
(509) 456-5902
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009319
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
185842
LABOR & INDUSTRIES
WA
05
—
8405334
—
WA
Enumeration date
03/21/2006
Last updated
12/11/2012
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