Provider Demographics
NPI:1083105373
Name:LIGORI, JONATHAN HECTOR (DPT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:HECTOR
Last Name:LIGORI
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3939 HOUMA BLVD
Mailing Address - Street 2:BLDG 5 STE 17
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70006
Mailing Address - Country:US
Mailing Address - Phone:504-885-9121
Mailing Address - Fax:504-885-0322
Practice Address - Street 1:3939 HOUMA BLVD
Practice Address - Street 2:BLDG 5 STE 17
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006
Practice Address - Country:US
Practice Address - Phone:504-885-9121
Practice Address - Fax:504-885-0322
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
LA09940225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist