Individual
MRS. PHILOMENA C BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT, MPHA, BSPT
Contact information
Practice address
2838 ANDREW AVE, PASCAGOULA, MS 39567-1802
(228) 762-2345
(228) 762-2365
Mailing address
2838 ANDREW AVE, PASCAGOULA, MS 39567-1802
(228) 762-2345
(228) 762-2365
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT0308
MS
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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