Individual
DR. MITCHELL NEIL BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5725 JOHNSTON ST, SUITE 2314, LAFAYETTE, LA 70503-5315
(337) 984-2410
(337) 984-2416
Mailing address
5725 JOHNSTON ST, SUITE 2314, LAFAYETTE, LA 70503-5315
(337) 984-2410
(337) 984-2416
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1105-195T
LA
Other
Enumeration date
09/30/2005
Last updated
02/20/2012
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