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1275197121
DEMETRIAL HOUSTON
SHREVEPORT, LA
NPI
1275197121
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-04-25
Last Update Date
2019-04-25
Business Address
DEMETRIAL HOUSTON
4571 N MARKET ST
SHREVEPORT, LA 71107-2917
Phone number: 318-424-8735
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Mailing Address
DEMETRIAL HOUSTON
4571 N MARKET ST
SHREVEPORT, LA 71107-2917
Phone number: 318-424-8735
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