Organization
CENTENNIAL SPORTS & PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SEAN FREEMAN PT (OWNER PHYSICAL THERAPIST)
(509) 928-6220
Entity
Organization
Contact information
Practice address
13102 E MISSION AVE, SPOKANE VALLEY, WA 99216-1142
(509) 928-6220
(509) 928-7597
Mailing address
13102 E MISSION AVE, SPOKANE VALLEY, WA 99216-1142
(509) 928-6220
(509) 928-7597
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00009613
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
196030
LABOR AND INDUSTRIES
WA
01
—
5230FR
ASURIS
WA
05
—
7136989
—
WA
01
—
DF5882
RR MEDICARE GROUP
WA
01
—
P00377246
RR MEDICARE
WA
Enumeration date
01/26/2007
Last updated
03/16/2015
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