Individual
DEMARCUS DWAYNE FRIELS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1140 SHIRLEY RD, BUNKIE, LA 71322-1545
(318) 346-8001
(318) 346-8005
Mailing address
1140 SHIRLEY RD, BUNKIE, LA 71322-1545
(318) 346-8001
(318) 346-8005
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1544761
—
LA
01
—
1679507412
NPI
LA
Enumeration date
04/12/2018
Last updated
04/12/2018
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