Individual
JUSTIN CONWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
46888 RIVERWOODS DR, MACOMB, MI 48044-5708
(313) 671-7062
Mailing address
46888 RIVERWOODS DR, MACOMB, MI 48044-5708
(313) 671-7062
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
4703110555
MI
Other
Enumeration date
09/18/2021
Last updated
09/18/2021
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