Individual
MR. JUSTIN RICHARD WALUKONIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
5301 MCAULEY DR, YPSILANTI, MI 48197-1051
(734) 712-3456
Mailing address
739 MEADOWLAKE RD, CANTON, MI 48188-1591
(248) 933-2192
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704322121
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704322121
MI
Other
Enumeration date
12/27/2022
Last updated
11/11/2024
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