Individual
MR. EDWARD JAMES BROUSSARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
411 HARRELL DR, LAFAYETTE, LA 70503-4822
(337) 984-9660
(337) 984-9660
Mailing address
411 HARRELL DR, LAFAYETTE, LA 70503-4822
(337) 984-9660
(337) 984-9660
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11752
LA
Other
Enumeration date
07/21/2009
Last updated
07/21/2009
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