Individual
MS. MELISSA BETH BROUSSEAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L., ATC.
Contact information
Practice address
19 PAYSON AVE, EASTHAMPTON, MA 01027-2246
(413) 529-3089
Mailing address
220 MAIN ST APT 1, EASTHAMPTON, MA 01027-2025
(413) 626-9709
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1004
MA
Other
Enumeration date
06/03/2020
Last updated
06/03/2020
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