Most Relevant Information
Provider Data
| NPI Number: | 1003294919 |
| Provider Name: | JEREMY BROUSSARD D.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 1741 |
Most Important Dates
| Enumeration Date: | 05/12/2015 |
| Last Updated: | 05/12/2015 |
Provider Practice Location
612 RUE DE ONETTA
NEW IBERIA
LA
705632163
Practice Location Phone/Fax
| Phone: | 3373676649 |
| Fax: |
Provider Mailing Location
612 RUE DE ONETTA
NEW IBERIA
LA
70563
Provider Mailing Phone/Fax
| Phone: | 3373676649 |
| Fax: |