Individual
DR. RUSSELL WARREN HEARNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT,DPT
Contact information
Practice address
192 HIGHWAY 3226, DERIDDER, LA 70634-8915
(936) 465-6282
Mailing address
1920 CAMPFIRE RD, LAKE CHARLES, LA 70611
(936) 465-6282
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
09007R
LA
Other
Enumeration date
03/14/2018
Last updated
03/14/2018
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