Cleon Sherrill Broussard in Tecumseh - Sports
Cleon Sherrill Broussard - NPI 1013992577
Cleon Sherrill Broussard is a Sports in Tecumseh, Michigan. Cleon Sherrill Broussard practices all healthcare services and medical treatments related to Sports. The NPI Number for Cleon Sherrill Broussard is 1013992577. The last update date is 2021-11-02.
Cleon Sherrill Broussard's current location address is 9224 Bramble Rd, Tecumseh, Michigan. You can contact this provider via phone number 5174382169. The mailing address for Cleon Sherrill Broussard is 9224 Bramble Rd, Tecumseh, Michigan. To know further, please read the information below!
Provider Profile Detail
Provider Name | Cleon Sherrill Broussard |
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Address | 9224 Bramble Rd, Tecumseh, Michigan |
Phone Number | 5174382169 |
Fax Number | |
Sole Proprietor | N |
Credentials | P.T. |
NPI Number Detail
NPI Number | 1013992577 |
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Provider Enumeration Date | 2005-12-07 |
Last Updated Date | 2021-11-02 |
Provider Mailing Address Detail
Address | 9224 Bramble Rd |
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City | Tecumseh |
State | Michigan (MI) |
Post Code | 492868712 |
Phone Number | 5174382169 |
Fax Number |
Provider's Primary Taxonomy Detail
Speciality | Sports |
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Taxonomy | 2251S0007X |
Licence No | 5501007019 |
Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, patholog |
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What is the unique 10-digit identification code assigned to Cleon Sherrill Broussard by the Centers for Medicare & Medicaid Services?
The Cleon Sherrill Broussard has been issued the NPI (National Provider Identifier) 1013992577, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you share the physical location details of Cleon Sherrill Broussard?
The Cleon Sherrill Broussard is situated at 9224 Bramble Rd, in the city of Tecumseh, state of MI, with the zip code 492868712.
What is Cleon Sherrill Broussard's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Cleon Sherrill Broussard is Sports, and the taxonomy code that classifies this field of practice is 2251S0007X.
On what date did the Cleon Sherrill Broussard receive its 1013992577 assignment from the Centers for Medicare & Medicaid Services?
The Cleon Sherrill Broussard was assigned its 1013992577 by the Centers for Medicare & Medicaid Services on 2005-12-07.
When was the information pertaining to Cleon Sherrill Broussard most recently updated or revised?
The details related to Cleon Sherrill Broussard, including its address, specialty, and other relevant information, were last updated or revised on 2021-11-02.