John Robert Broussard

NPI 1013271196 - Counselor - 101YM0800X

NPI Details
NPI 1013271196
Gender Male
Enumeration Date 07/03/2012
Last Updated 07/03/2012
Entity Type Individual
Active Over 4 years ago
Practice Location
2711 EDGEWOOD DR
PLACERVILLE CA, 95667-3409, US
Phone (530) 306-1816
Fax
Business Location
2711 EDGEWOOD DR
PLACERVILLE CA, 95667-3409, US
Phone (530) 306-1816
Fax
Toxanomy
Taxonomy Code 101YM0800X
License State
License Number
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According to our database, Mr. John Robert Broussard NPI is 1013271196, taxonomy code is 101YM0800X John Robert Broussard physically located at 2711 Edgewood Dr, Placerville CA, 95667-3409. NPI Number John Robert Broussard has the Individual type.

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1013271196 NPI number is provided on an as is basis without warranty of any kind. 1013271196 is maintained by the National Plan & Provider Enumeration System. The contents of John Robert Broussard are for informational purposes only.