Individual
DEMOND LAVAR SHIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
E.M.T.
Contact information
Practice address
130 BARTON CV, MARION, AR 72364-1601
(901) 828-8832
Mailing address
130 BARTON CV, MARION, AR 72364-1601
(901) 828-8832
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
23601
AR
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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