Individual
JOHN ADAM BROUSSARD JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
10089 FOLSOM BLVD STE A, RANCHO CORDOVA, CA 95670-1935
(916) 366-6531
Mailing address
5105 HEATHER RANCH WAY, RANCHO CORDOVA, CA 95742-8180
(916) 494-8511
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN150240
CA
Other
Enumeration date
04/25/2024
Last updated
04/25/2024
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