Individual
MR. CRAIG ROBERT BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
1021 E LAUREL AVE, EUNICE, LA 70535-3611
(337) 546-0101
(337) 546-0071
Mailing address
107 BRIARMEADOW DR, LAFAYETTE, LA 70508-7210
(337) 303-3237
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTT.Z11165
LA
Other
Enumeration date
09/17/2006
Last updated
07/08/2007
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