Individual
MICHAEL ALLEN BROUSSEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1833 E BISMARCK EXPY, BISMARCK, ND 58504-6708
(701) 323-5222
Mailing address
1833 E BISMARCK EXPY, BISMARCK, ND 58504-6708
(701) 323-5222
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1537
ND
Other
Enumeration date
06/16/2009
Last updated
06/16/2009
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