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1346241007
MALCOLM J BROUSSARD
BATON ROUGE, LA
NPI
1346241007
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: LA 11396)
Enumeration Date
2005-08-03
Last Update Date
2011-04-07
Business Address
Mr. MALCOLM J BROUSSARD
3388 BRENTWOOD DR
BATON ROUGE, LA 70809-1700
Phone number: 225-925-6481
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Mailing Address
Mr. MALCOLM J BROUSSARD
3388 BRENTWOOD DR
BATON ROUGE, LA 70809-1700
Phone number: 225-925-6481
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