| Organization Name: | BROUSSARD PHYSICAL THERAPY CLINIC, INC. |
| NPI Number: | 1356478119 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES KEITH BROUSSARD (PHYSICAL THERAPIST) |
| Mailing Address: | 295 Highland Dr Many |
| State: | LA US |
| Postal Code: | 714493717 |
| Phone Number: | 3182566285 |
| Fax Number: | 3182566658 |
| NPI Enumeration Date: | 02/28/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | PT00257 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | LA |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |