Individual
DR. REBECCA KOHARA BROUSSARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T., D.P.T.
Contact information
Practice address
309 S WASHINGTON ST, DERIDDER, LA 70634-4861
(337) 462-6097
(337) 462-0531
Mailing address
309 S WASHINGTON ST, DERIDDER, LA 70634-4861
(337) 462-6097
(337) 462-0531
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00504
LA
Other
Enumeration date
03/12/2010
Last updated
03/12/2010
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