Individual
GERALD BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.P.H.
Contact information
Practice address
805 CENTER ST, NEW IBERIA, LA 70560-5505
(337) 364-0464
Mailing address
17724 LOUISIANA HIGHWAY 331, ERATH, LA 70533
(337) 937-8416
(337) 364-0465
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
9747
LA
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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