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Individual

WILFRED BROUSSARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.AP

Contact information

Practice address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 355-2335
Mailing address
1115 WEBER ST, FRANKLIN, LA 70538-4124
(337) 828-2550
(337) 828-5411

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
A10127
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1624888
LA
Enumeration date
06/12/2006
Last updated
02/22/2019
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