Broussard Physical Therapy Clinic, Inc.
Organization Active NPI Specialist · Many, LA
NPI 1356478119 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1356478119
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- PT00257 (LA)
- Legal business name
- BROUSSARD PHYSICAL THERAPY CLINIC, INC.
- Practice address
- 295 Highland Dr
Many, LA 71449-3717 - Phone
- (318) 256-6285
- Fax
- (318) 256-6658
- NPI assigned
- Feb 28, 2007
- Organization subpart
- No
Authorized official
- Name
- Mr. James Keith Broussard, P.T.
- Title
- Physical Therapist
- Phone
- (318) 256-6285
Practitioners 1
-
Constance Faith Welcome, LOTR
National Provider Directory
Locations
295 Highland Dr
Many, LA 71449
Phone (318) 256-6285
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | PT00257 | LA | Yes |
Addresses
Primary practice location
295 Highland Dr
Many, LA 71449-3717
Mailing address
295 Highland Dr
Many, LA 71449-3717
Phone (318) 256-6285
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8882891 | Other | LA | CIGNA I.D. # |
| 7568170 | Other | LA | AETNA I.D. # |
Other providers in Many, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.