Organization
CENTENNIAL ANESTHESIA PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY JOHNSON (OWNER)
(509) 413-3147
Entity
Organization
Contact information
Practice address
1725 W STAPLES RD, POST FALLS, ID 83854-8832
(509) 413-3147
Mailing address
1725 W STAPLES RD, POST FALLS, ID 83854-8832
(509) 413-3147
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
—
—
Other
Enumeration date
12/16/2021
Last updated
12/16/2021
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