Individual
MR. JUSTIN ERIC CIECKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3990 JOHN R ST, DETROIT, MI 48201-2018
(313) 745-7600
Mailing address
53866 OAKVIEW DR, SHELBY TOWNSHIP, MI 48315-1925
(586) 944-8020
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704259917
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
4704259917
MI
Other
Enumeration date
01/04/2012
Last updated
06/07/2023
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