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1407481393
DEJAE ANTRELL BROOMFIELD
HOUMA, LA
NPI
1407481393
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2020-03-11
Last Update Date
2020-03-11
Business Address
DEJAE ANTRELL BROOMFIELD
320 PROGRESSIVE BLVD
HOUMA, LA 70360-4069
Phone number: 985-303-6090
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Mailing Address
DEJAE ANTRELL BROOMFIELD
320 PROGRESSIVE BLVD
HOUMA, LA 70360-4069
Phone number: 985-303-6090
Copy
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