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: |