MEDICARE: ROAM PT PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1205706215
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROAM PT PLLC

Provider Business Mailing Address
First Line	:	192 GREGGS CT
Second Line	:
City	:	NEWPORT
State	:	WA
Zip	:	99156-9152
Country	:	US
Telephone Number	:	509-570-8315
Fax Number	:	509-570-8315

Provider Business Practice Location Address
First Line	:	192 GREGGS CT
Second Line	:
City	:	NEWPORT
State	:	WA
Zip	:	99156-9152
Country	:	US
Telephone Number	:	509-570-8315
Fax Number	:	509-570-8315

Authorized Official
Title or Position	:	DOCTOR OF PHYSICAL THERAPY
Name	:	LOUIS JOHN CERENZIA
Credential	:	PT, DPT
Telephone Number	:	509-570-8315

Provider Enumeration Date	:	11/06/2025
Last Update Date	:	12/22/2025

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