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1497039812
BRIAN RAY RUSSELL
WEST MONROE, LA
NPI
1497039812
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: LA 08166)
Enumeration Date
2011-10-04
Last Update Date
2011-10-04
Business Address
-- BRIAN RAY RUSSELL DPT
107 SUMMER LN
WEST MONROE, LA 71291-3501
Phone number: 318-396-1969
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Mailing Address
-- BRIAN RAY RUSSELL DPT
107 SUMMER LN
WEST MONROE, LA 71291-3501
Phone number: 318-396-1969
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