Individual
MR. MALCOLM J BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3388 BRENTWOOD DR, BATON ROUGE, LA 70809-1700
(225) 925-6481
(225) 922-0316
Mailing address
3388 BRENTWOOD DR, BATON ROUGE, LA 70809-1700
(225) 925-6481
(225) 922-0316
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
11396
LA
Other
Enumeration date
08/03/2005
Last updated
04/07/2011
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