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Organization
RUSSELL PHYSICAL THERAPY
Active
Organization
RUSSELL PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DALTON RUSSELL DPT (OWNER)
(318) 282-5468
Entity
Organization
Contact information
Practice address
208 E MAIN ST, OAK GROVE, LA 71263-2557
(318) 282-5468
Mailing address
324 PULLTIGHT RD, OAK GROVE, LA 71263-9187
(318) 282-5468
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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