NPI 1134319544

Jessica Ford Broussard, OTRL

Practitioner Mechanotherapist Fremont, NE

Practice location

Address: 1005 E 23rd St Suite 200, Fremont, NE 68025-0800
Phone: (866) 784-2329
Mailing address: 7117 Glendale St, Metairie, LA 70003-3103

Registered specialties

Mechanotherapist Primary

Other Service Providers Taxonomy 172M00000X Licence Z11945 (LA)

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Registry record

NPI: 1134319544
Entity type: Individual
Sex (as registered): Female
NPI issued: 1 Aug 2007
Record last updated: 1 Aug 2007

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.