| NPI | 1912572025 |
|---|---|
| Other Name | DISTEFANO'S OSTEOPRACTIC PHYSICAL THERARPY |
| Entity Type | Organization |
| Authorized Contact | DOUGLAS LOGAN DISTEFANO Owner 318-792-7987 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-05-21 |