| Doctor Name: | JUSTIN PAUL BROUHARD |
| NPI Number: | 1982041208 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | |
| Business Practice Address: | 343 S Moorpark Rd Thousand Oaks, CA - 913611008 |
| Business Phone Number: | 8054130160 |
| Business Fax Number: | 8054130161 |
| Mailing Address: | 8510 Balboa Blvd, Ste 150 NORTHRIDGE |
| State: | CA |
| Postal Code: | 913253583 |
| Phone Number: | 8186543400 |
| Fax Number: | 8186543417 |
| NPI Enumeration Date: | 05/28/2013 |
| NPI Last Update Date: | 05/28/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |