Individual
KANON BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16405 NORTHCROSS DR, SUITE G-2, HUNTERSVILLE, NC 28078-5091
(866) 214-9644
Mailing address
16405 NORTHCROSS DR, SUITE G-2, HUNTERSVILLE, NC 28078-5091
(866) 214-9644
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09393
LA
Other
Enumeration date
07/08/2016
Last updated
07/08/2016
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