Individual
JOHN R KUKSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1915 N PERRY ST, PONTIAC, MI 48340-2237
(615) 778-4066
Mailing address
5080 SPECTRUM DR, SUITE 1200 WEST, ADDISON, TX 75001-4648
(972) 364-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001196
MI
Other
Enumeration date
04/03/2007
Last updated
06/30/2009
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