Individual
MR. JORDAN JOSEPH BONFIGLIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1100 C M FAGAN DR STE 103, HAMMOND, LA 70403-5963
(985) 542-6664
(985) 542-6428
Mailing address
1100 C M FAGAN DR STE 103, HAMMOND, LA 70403-5963
(985) 542-6664
(985) 542-6428
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10630
LA
Other
Enumeration date
06/23/2020
Last updated
06/23/2020
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