Individual
MRS. CLEON SHERRILL BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
9224 BRAMBLE RD, TECUMSEH, MI 49286-8712
(517) 438-2169
Mailing address
9224 BRAMBLE RD, TECUMSEH, MI 49286-8712
(517) 438-2169
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501007019
MI
2251G0304X
Geriatric Physical Therapist
5501007019
MI
2251N0400X
Neurology Physical Therapist
5501007019
MI
2251P0200X
Pediatric Physical Therapist
Primary
5501007019
MI
2251S0007X
Sports Physical Therapist
5501007019
MI
2251X0800X
Orthopedic Physical Therapist
5501007019
MI
Other
Enumeration date
12/07/2005
Last updated
11/02/2021
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