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1619241064
GREG A BROUSSARD
LAFAYETTE, LA
NPI
1619241064
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: LA RN112825AP06765)
Enumeration Date
2012-03-02
Last Update Date
2012-03-02
Business Address
-- GREG A BROUSSARD CRNA
4801 AMBASSADOR CAFFERY PKWY
LAFAYETTE, LA 70508-6917
Phone number: 337-470-2966
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Mailing Address
-- GREG A BROUSSARD CRNA
PO BOX 53864
LAFAYETTE, LA 70505-3864
Phone number: 337-470-2966
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