Individual
CHAUNCEY DYER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1533 MARSHALL ST, SHREVEPORT, LA 71101-3941
(318) 626-5597
Mailing address
1533 MARSHALL ST, SHREVEPORT, LA 71101-3941
(318) 626-5597
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
LA
225400000X
Rehabilitation Practitioner
Primary
—
—
Other
Enumeration date
08/13/2010
Last updated
05/27/2026
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