Provider Demographics
NPI:1245613629
Name:LIGON, PATRICIA ROTELLA (DPT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ROTELLA
Last Name:LIGON
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3135 KIRBY WHITTEN RD STE 105
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-2860
Mailing Address - Country:US
Mailing Address - Phone:865-223-3098
Mailing Address - Fax:
Practice Address - Street 1:3135 KIRBY WHITTEN RD STE 105-106
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-2860
Practice Address - Country:US
Practice Address - Phone:901-213-2900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-03
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61128208100000X
2251X0800X
TN10383225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic