Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KELLY M BROUSSARD, DPT
Active Sole ProprietorDR. KELLY M BROUSSARD, DPT is a Physical Therapy Assistant healthcare provider located in LELAND, North Carolina. NPI 1801433958 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · LELAND, NC
Registration Details
- NPI Number
- 1801433958
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Dec 9, 2019 (6.5336211728823 yrs)
- Last Updated
- Sep 3, 2025
- Licenses
-
27089 (MD)P18088 (NC)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1168 E CUTLAR XINGLELAND, NC, 284516484Browse NC providers · Browse ZIP 28451
- Phone
- 9193323800
- Fax
- 9192510421
- Primary Specialty
-
Physical Therapy Assistant
225100000X
- Additional Specialty
- Physical Therapy Assistant
Other Physical Therapy Assistant Providers in LELAND, NC
| Name | Credential | NPI |
|---|---|---|
| MR. BRIAN C TANTILLA | P.T. | 1851307441 |
| TEAL THAYER BUSTEED | PT | 1184742199 |
| LESLIE GRAVINA | PT | 1467648030 |
| CORI ADAMS | PT | 1356506133 |
| ANDREW RYAN SJOLANDER | PT | 1144477159 |
| TIFFANE BENNETT O'NEIL | — | 1093957540 |
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.