Broussard, Jody Mack
Broussard, Jody Mack is an sole proprietor health care provider with primary practice located at 494 Otto Franklin Rd , Deridder LA 70634-6404. He recently has only one registered license in Other Service Providers / Driver, which is considered as his primary health care specialty. Broussard, Jody Mack can be contacted via phone (337) 396-1312.Contact Information
Primary practice address
494 Otto Franklin Rd
Deridder LA 70634-6404
Phone: (337) 396-1312
Fax: (337) 462-0283
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Driver | 172A00000X | 005855942 | Louisiana |
Profile Details
| NPI number | 1659871796 |
|---|---|
| LBN Legal business name | Broussard, Jody Mack |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 15th, 2018 |
| Last updated | Feb 15th, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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