JACOB PAUL BROUSSARD

ERATH, LA
NPI1184248684
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: LA  ATH.200192)
Enumeration Date2020-06-01
Last Update Date2020-06-01
Business Address
Mr. JACOB PAUL BROUSSARD ATC, LAT
808 S BROADWAY ST
ERATH, LA 70533-4014
Phone number: 337-937-8451
Mailing Address
Mr. JACOB PAUL BROUSSARD ATC, LAT
408 PEAR TREE CIR
BROUSSARD, LA 70518-7237
Phone number: