Provider Demographics
NPI:1598992760
Name:VALIGORA, WILLIAM SHANE (DPT)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:SHANE
Last Name:VALIGORA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:789 HIGHWAY 96 STE 2B
Mailing Address - Street 2:
Mailing Address - City:BONAIRE
Mailing Address - State:GA
Mailing Address - Zip Code:31005-3357
Mailing Address - Country:US
Mailing Address - Phone:478-302-5111
Mailing Address - Fax:478-225-6453
Practice Address - Street 1:789 HIGHWAY 96 STE 2B
Practice Address - Street 2:
Practice Address - City:BONAIRE
Practice Address - State:GA
Practice Address - Zip Code:31005-3357
Practice Address - Country:US
Practice Address - Phone:478-302-5111
Practice Address - Fax:478-225-6453
Is Sole Proprietor?:No
Enumeration Date:2009-06-16
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010208225100000X
SC5607225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist