Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JACOB PAUL BROUSSARD, ATC, LAT
ActiveMR. JACOB PAUL BROUSSARD, ATC, LAT is a Athletic Trainer healthcare provider located in ERATH, Louisiana. NPI 1184248684 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · ERATH, LA
Registration Details
- NPI Number
- 1184248684
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jun 1, 2020 (6.0207001365552 yrs)
- Last Updated
- Jun 1, 2020
- License
-
ATH.200192 (LA)
Practice Information
- Address
-
808 S BROADWAY STERATH, LA, 705334014Browse LA providers · Browse ZIP 70533
- Phone
- 3379378451
- Primary Specialty
-
Athletic Trainer
2255A2300X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.