NPI 1003294919

Jeremy Broussard, DC

Practitioner Chiropractor New Iberia, LA

Practice location

Address: 612 Rue de Onetta, New Iberia, LA 70563-2163
Phone: (337) 367-6649
Mailing address: 612 Rue de Onetta, New Iberia, LA 70563

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence 1741 (LA)

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Registry record

NPI: 1003294919
Entity type: Individual
Sex (as registered): Male
NPI issued: 12 May 2015
Record last updated: 12 May 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.