Individual
JOSEPH L MARCILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
212 WALSH DR, PINOPOLIS, SC 29469-5073
(816) 665-1117
Mailing address
212 WALSH DR, PINOPOLIS, SC 29469-5073
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
75585
KS
Other
Enumeration date
06/24/2021
Last updated
06/24/2021
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