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Roberta Ruth Broussard, LMT
Massage Therapist in Pensacola, Florida
NPI 1770761256

Roberta Ruth Broussard is a Massage Therapist based in Pensacola, FL. Roberta Ruth Broussard practices in Pensacola, FL and has the professional credentials of LMT. The NPI Number for Roberta Ruth Broussard is 1770761256 and holds a License No. MA33306 (Florida).

The current practice location address for Roberta Ruth Broussard is 4400 Bayou Blvd, Pensacola, FL and can be reached out via phone at 850-516-4574.

Location: 4400 Bayou Blvd, Pensacola, FL, 32503-2673
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1770761256
Provider Name
Roberta Ruth Broussard
Credential
LMT
Provider Entity Type
Individual
Gender
Female
Address
4400 Bayou Blvd, Pensacola, FL, 32503-2673
Phone Number
850-516-4574
Fax Number
Provider Enumeration Date
02/06/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
C2164 01 FL BLUE CROSS BLUE SHIELD
institution
Provider Business Practice Location Address Details
Address
4400 Bayou Blvd
City
Pensacola
State
Florida
Zip
32503-2673
Phone Number
850-516-4574
Fax Number
person
Provider Business Mailing Address Details
Address
4400 Bayou Blvd
City
Pensacola
State
Florida
Zip
32503-2673
Phone Number
850-516-4574
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MA33306 (Florida)
Definition
An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.
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