Individual
JONATHAN LYSKAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
64 FAIRWOOD BLVD, PLEASANT RIDGE, MI 48069-1217
(248) 342-2885
Mailing address
64 FAIRWOOD BLVD, PLEASANT RIDGE, MI 48069-1217
(248) 342-2885
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
04/25/2016
Last updated
04/25/2016
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