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Michael Broussard, PT
Specialist in Zachary, Louisiana
NPI 1063966026

Michael Broussard is a Specialist based in Zachary, LA. Michael Broussard practices in Zachary, LA and has the professional credentials of PT. The NPI Number for Michael Broussard is 1063966026 and holds a License No. 09455 (Louisiana).

The current practice location address for Michael Broussard is 1326 Church St, Zachary, LA and can be reached out via phone at 225-654-8208 and via fax at 225-654-4642.

Location: 1326 Church St, Zachary, LA, 70791-2743
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063966026
Provider Name
Michael Broussard
Credential
PT
Provider Entity Type
Individual
Gender
Male
Address
1326 Church St, Zachary, LA, 70791-2743
Phone Number
225-654-8208
Fax Number
225-654-4642
Provider Enumeration Date
08/08/2016
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1326 Church St
City
Zachary
State
Louisiana
Zip
70791-2743
Phone Number
225-654-8208
Fax Number
225-654-4642
person
Provider Business Mailing Address Details
Address
1326 Church St
City
Zachary
State
Louisiana
Zip
70791-2743
Phone Number
225-654-8208
Fax Number
225-654-4642
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
09455 (Louisiana)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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