MEDICARE: JAYDA LIGGONS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist		GA

General Provider Information

NPI Number	:	1346174398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAYDA LIGGONS

Provider Business Mailing Address
First Line	:	875 MANSELL RD STE H
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-4800
Country	:	US
Telephone Number	:	678-821-2170
Fax Number	:

Provider Business Practice Location Address
First Line	:	875 MANSELL RD STE H
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30076-4800
Country	:	US
Telephone Number	:	678-821-2170
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ JAYDA LIGGONS ” Practice Location

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