Individual
DR. LATRESIA GRACE BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DC
Contact information
Practice address
331 HOSPITAL RD, NEW ROADS, LA 70760-2622
(225) 618-8016
(225) 618-8028
Mailing address
331 HOSPITAL RD, NEW ROADS, LA 70760-2622
(225) 618-8016
(225) 618-8028
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1307
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1509060
—
LA
Enumeration date
11/21/2006
Last updated
07/08/2007
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