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General NPI Number Information
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NPI Number | 1053204941
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Entity Type | Individual
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Provider Name | DOUGLAS DEEN MSPT
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Gender | Male
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Dates
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Enumeration Date | 05/30/2025
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Last Update Date | 05/30/2025
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Provider Practice Location Address
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Address Line | 10825 FINANCIAL CENTRE PKWY STE 210
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City | LITTLE ROCK
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State | AR
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Zip | 72211-3545
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Country | US
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Telephone | 501-223-8310
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Fax |
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Provider Business Mailing Address
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Address Line | 4305 GAZEBO DR
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City | CONWAY
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State | AR
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Zip | 72034-8260
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Country | US
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Telephone | 501-472-0980
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT1752
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License Number State | AR
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