Organization
DO PT LLC
Active
Organization
DO PT LLC
Active
Other names
Blue Rose Physical Therapy - Saline, Distefano's Osteopractic Physical Therarpy
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS LOGAN DISTEFANO PT, DPT, FAAOMPT (CO-OWNER)
(501) 915-4354
Entity
Organization
Contact information
Practice address
1214 SALEM ROAD, SUITE A, BENTON, AR 72019
(318) 792-7987
(501) 457-9090
Mailing address
1214 SALEM RD STE A, BENTON, AR 72019-8340
(501) 915-4354
(501) 457-9090
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
05/21/2021
Last updated
07/13/2026
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