Individual
EVA BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
260 SAM HOUSTON JONES PKWY, LAKE CHARLES, LA 70611-5603
(337) 214-6402
Mailing address
1776 CRAWFORD DR, LAKE CHARLES, LA 70611-4661
(337) 515-6579
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PST.011753
LA
Other
Enumeration date
02/25/2021
Last updated
02/25/2021
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