Provider Demographics
NPI:1578970992
Name:BADJI, MOUHAMED LAMINE (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:MOUHAMED
Middle Name:LAMINE
Last Name:BADJI
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:248 LENOX BRG
Mailing Address - Street 2:
Mailing Address - City:STERLINGTON
Mailing Address - State:LA
Mailing Address - Zip Code:71280-3346
Mailing Address - Country:US
Mailing Address - Phone:318-557-7985
Mailing Address - Fax:
Practice Address - Street 1:4075 STERLINGTON RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:LA
Practice Address - Zip Code:71203-2535
Practice Address - Country:US
Practice Address - Phone:318-557-7985
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-17
Last Update Date:2014-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA06782225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist