Individual
BRIAN PAUL BROUSSARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
111 2ND AVE NE STE 1401, ST PETERSBURG, FL 33701-3480
(727) 258-7224
Mailing address
111 2ND AVE NE STE 1401, ST PETERSBURG, FL 33701-3480
(727) 258-7224
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
1679719421
VA
2251S0007X
Sports Physical Therapist
Primary
PT34062
FL
Other
Enumeration date
09/02/2017
Last updated
06/09/2021
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