Individual
DR. JEREMY BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
612 RUE DE ONETTA, NEW IBERIA, LA 70563-2163
(337) 367-6649
Mailing address
612 RUE DE ONETTA, NEW IBERIA, LA 70563
(337) 367-6649
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1741
LA
Other
Enumeration date
05/12/2015
Last updated
05/12/2015
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