Provider Demographics
NPI:1669594677
Name:DELIZO, LIGAYA PONO (RPT)
Entity type:Individual
Prefix:
First Name:LIGAYA
Middle Name:PONO
Last Name:DELIZO
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:LIGAYA
Other - Middle Name:ALIMPANGOG
Other - Last Name:PONO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1010 FALLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:POTTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19464-1745
Mailing Address - Country:US
Mailing Address - Phone:484-542-0273
Mailing Address - Fax:
Practice Address - Street 1:1000 E WYOMISSING BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-1764
Practice Address - Country:US
Practice Address - Phone:610-376-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT 009499L225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist