Individual
DIVINAGRACIA JUCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1 WILLIAM CARLS DR, COMMERCE TOWNSHIP, MI 48382-2201
(248) 937-3300
Mailing address
1 WILLIAM CARLS DR ANESTHESIA DEPARTMENT, COMMERCE TOWNSHIP, MI 48382
(248) 937-5141
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704128866
MI
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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