Individual
MONICA BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A. - C
Contact information
Practice address
6465 S YALE AVE, SUITE 420, TULSA, OK 74136-7823
(918) 502-8810
Mailing address
6767 SOUTH YALE AVENUE, SUITE A, TULSA, OK 74136
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2365
OK
Other
Enumeration date
03/24/2014
Last updated
07/06/2017
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