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1285405159
PHILIP BRANDON BROUSSARD
SHREVEPORT, LA
NPI
1285405159
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: LA CIT-5418)
Enumeration Date
2024-01-10
Last Update Date
2024-01-10
Business Address
PHILIP BRANDON BROUSSARD CIT
7330 FERN AVE STE 1003
SHREVEPORT, LA 71105-4988
Phone number: 318-550-5490
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Mailing Address
PHILIP BRANDON BROUSSARD CIT
7330 FERN AVE STE 1003
SHREVEPORT, LA 71105-4988
Phone number: 318-550-5490
Copy
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