Individual
MRS. SANDRA LEE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1850 ELM ST, MANCHESTER, NH 03104-2911
(603) 641-4800
Mailing address
1850 ELM ST, MANCHESTER, NH 03104-2911
(603) 641-4800
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
1729
NH
Other
Enumeration date
01/29/2020
Last updated
01/29/2020
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