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Organization

CENTENNIAL SPORTS & PHYSICAL THERAPY LLC

Active
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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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