Individual
DANIEL JAMES BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
727 WELSH RD STE 103, HUNTINGDON VALLEY, PA 19006-6357
(215) 947-7550
(215) 947-0590
Mailing address
727 WELSH RD STE 103, HUNTINGDON VALLEY, PA 19006-6357
(215) 947-7550
(215) 947-0590
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA004910
PA
363AS0400X
Surgical Physician Assistant
OA004910
PA
Other
Enumeration date
06/08/2018
Last updated
10/23/2020
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