Individual
MR. RUSSELL MARCILIS II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
18121 E. 8 MILE STE 100, EASTPOINTE, MI 48021
(586) 585-1446
Mailing address
11885 E 12 MILE RD STE 200B, WARREN, MI 48093-3474
(313) 799-7935
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
MI
Other
Enumeration date
08/18/2015
Last updated
01/04/2016
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