Healthcare Provider Details

I. General information

NPI: 1285612150
Provider Name (Legal Business Name): MERIL JOSEPH DUFRENE, JR. D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2006
Last Update Date: 06/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3327 JACKSON ST SUITE F
ALEXANDRIA LA
71301-3372
US

IV. Provider business mailing address

3327 JACKSON ST SUITE F
ALEXANDRIA LA
71301-3372
US

V. Phone/Fax

Practice location:
  • Phone: 318-445-2513
  • Fax: 318-445-2910
Mailing address:
  • Phone: 318-445-2513
  • Fax: 318-445-2910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number761
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: