Search › Louisiana › 172A00000X
Jody Broussard
NPI 1659871796 · on the registry since 2018 · sole proprietor
Practice
- Address
- 494 Otto Franklin Rd
Deridder, LA 70634 - Phone
- (337) 396-1312
- Fax
- (337) 462-0283
Registry record
- Primary taxonomy
- 172A00000X
172A00000X
- Licence states on file
- LA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2018-02-15
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Louisiana