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1376744771
JASON BROUSSARD
SHREVEPORT, LA
NPI
1376744771
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: LA DO.000136)
Enumeration Date
2007-05-31
Last Update Date
2022-10-04
Business Address
JASON BROUSSARD D.O.
1111 LINE AVE FL 3
SHREVEPORT, LA 71101-3841
Phone number: 318-716-4610
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Mailing Address
JASON BROUSSARD D.O.
1111 LINE AVE FL 3
SHREVEPORT, LA 71101-3841
Phone number: 318-716-4610
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