Individual
BRADY D MALBROUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
602 N ACADIA RD, THIBODAUX, LA 70301-4823
(985) 447-5500
(904) 265-8181
Mailing address
PO BOX 123690, DEPT. 3690, DALLAS, TX 75312-3690
(855) 686-8430
(904) 265-8181
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP09161
LA
Other
Enumeration date
03/09/2017
Last updated
03/09/2017
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