Organization
BROUSSARD PHYSICAL THERAPY CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES KEITH BROUSSARD P.T. (PHYSICAL THERAPIST)
(318) 256-6285
Entity
Organization
Contact information
Practice address
295 HIGHLAND DR, MANY, LA 71449-3717
(318) 256-6285
(318) 256-6658
Mailing address
295 HIGHLAND DR, MANY, LA 71449-3717
(318) 256-6285
(318) 256-6658
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00257
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7568170
AETNA I.D. #
LA
01
—
8882891
CIGNA I.D. #
LA
Enumeration date
02/28/2007
Last updated
08/22/2020
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