Most Relevant Information
Provider Data
| NPI Number: | 1003384041 |
| Provider Name: | DEMOND LAVAR SHIELDS E.M.T. |
| Entity Type: | Individual |
| Taxonomy Code: | 146N00000X |
| Specialty: | Emergency Medical Technician, Basic |
| License Number: | 23601 |
Most Important Dates
| Enumeration Date: | 11/07/2018 |
| Last Updated: | 11/07/2018 |
Provider Practice Location
130 BARTON CV
MARION
AR
723641601
Practice Location Phone/Fax
| Phone: | 9018288832 |
| Fax: |
Provider Mailing Location
130 BARTON CV
MARION
AR
723641601
Provider Mailing Phone/Fax
| Phone: | 9018288832 |
| Fax: |