Individual
RUSSELL DUANE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COMS, COTA/L
Contact information
Practice address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
(734) 936-7070
Mailing address
1500 E MEDICAL CENTER DR, ANN ARBOR, MI 48109-5000
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5202006160
MI
Other
Enumeration date
12/12/2023
Last updated
12/12/2023
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