Individual
DR. ALEXIS NOELLE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
280 HARBISON BLVD STE T, COLUMBIA, SC 29212-2247
(803) 732-9200
Mailing address
8704 SOUTHAMPTON DR, MIRAMAR, FL 33025-2716
(504) 481-0472
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2085
SC
Other
Enumeration date
07/26/2018
Last updated
07/26/2018
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