Individual
MATT DESTEFANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
317 E COLORADO AVE, BALANCED THERAPY, LLC, TELLURIDE, CO 81435
(970) 728-8948
Mailing address
PO BOX 2512, TELLURIDE, CO 81435-2512
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL.0015370
CO
Other
Enumeration date
03/06/2018
Last updated
03/06/2018
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