MEDICARE: DR. MOUHAMED LAMINE BADJI PT, DPT

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	06782	LA

General Provider Information

NPI Number	:	1578970992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MOUHAMED LAMINE BADJI PT, DPT

Provider Business Mailing Address
First Line	:	248 LENOX BRG
Second Line	:
City	:	STERLINGTON
State	:	LA
Zip	:	71280-3346
Country	:	US
Telephone Number	:	318-557-7985
Fax Number	:

Provider Business Practice Location Address
First Line	:	4075 STERLINGTON RD
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71203-2535
Country	:	US
Telephone Number	:	318-557-7985
Fax Number	:

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

Provider Enumeration Date	:	07/17/2014
Last Update Date	:	07/17/2014

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