Organization
BLUE ROSE PHYSICAL THERAPY LLC
Active
Other names
Blue Rose Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN JERRY DOCKERY PT, DPT, PHD (PHYSICAL THERAPIST/OWNER)
(501) 904-2778
Entity
Organization
Contact information
Practice address
5013 JOHN F KENNEDY BLVD, NORTH LITTLE ROCK, AR 72116-6720
(501) 904-2778
(866) 724-7887
Mailing address
PO BOX 15538, LITTLE ROCK, AR 72231-5538
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
06/17/2021
Last updated
09/05/2021
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