Certified Registered Nurse Anesthetist

Ann Arbor, Michigan


Employer: Veterans Health Administration
Industry: Nurse
Salary: Competitive
Job type: Full-Time

Summary

The Certified Registered Nurse Anesthetist is an advanced practice nurse who utilizes specialized clinical nursing skills and is prepared to administer anesthesia care. As independently licensed health professionals, CRNAs are responsible and accountable for their practice. The scope of practice includes direct patient care, administration, educational, and research activities.

A recruitment incentive may be available for highly qualified external applicants.

This job is open to

  • Internal to an agency

    Current federal employees of this agency.
  • The public

    U.S. Citizens, Nationals or those who owe allegiance to the U.S.
  • Veterans


Videos

Duties

VA offers a comprehensive total rewards package: VA Nurse Total Rewards

Duties and responsibilities include, but are not limited to, the following:
  • Performs a pre-anesthetic patient assessment based on patient interview, patient history, lab results, and type of surgical procedure to be performed. Patient assignments per Chief Nurse Anesthetist or another designed person.
  • Selects and administers pre-anesthetic medication according to established protocol.
  • Requests and evaluates pertinent laboratory studies, pulmonary function studies, including blood gases, respiratory therapy, and other appropriate studies under established protocol.
  • Inserts intravenous catheters, according to established protocol, Swan-Ganz catheters and central venous pressure catheters under medical supervision, and arterial catheters; perform puncture for blood gases.
  • Utilizes all current techniques in monitoring.
  • Performs endotracheal intubation and extubation.
  • Selects and administers anesthetic techniques (intravenous, regional, various field blocks, or inhalational), medications/ adjunct drugs appropriate to the individual patient's condition and procedure (surgical or non-surgical) within established protocols in the operating suite and any off-site location (i.e. Endoscopy, Radiology, Cardiology, MRI, etc.).
  • Manages fluid, blood and electrolyte therapy within a medical care plan.
  • Initiates and modifies therapies, (i.e. drug and pain therapy) within established protocols.
  • Examines patients in post-anesthesia recovery/hospital units to assess patient's reaction to anesthetic management. Identifies any complications or abnormal patient responses to anesthesia or to adjunctive medication and implement appropriate management techniques.
  • Assists in the treatment and management of emergency airway problems throughout the hospital. Participates in cardiopulmonary resuscitation by performing airway management including endotracheal intubations. Serves as code captain in the absence of a physician.
  • Provides anesthetic consultation to physicians, nurses, and other hospital staff.
  • Makes post-operative rounds and records to patient's permanent record the presence or absence of anesthesia-related-complications.
  • Takes an active role in the departmental in-service program.
  • Takes emergency calls assigned by Chief Nurse Anesthetist or another designated person
  • Responsible for patient care activities for adult and geriatric patients, modifying treatment plans to accommodate the changes that occur with aging.
  • Safeguards sensitive data per provisions of the Privacy Act of 1974 and other applicable laws, federal regulations. VA statutes and policies.
  • Sets up, properly uses, reprocesses, and maintains all unit/department-specific equipment in accordance with equipment Standard Operating Procedure, with validation of ongoing competency at least annually.
  • Demonstrates the knowledge and ability to implement The Joint Commission standards to improve patient care outcomes.
  • Provides guidance and instruction in preparing others for positions of leadership and ethical practices which impact patient care.
  • Participates in the development of anesthesia patient care audit processes involving in depth review and analysis of anesthesia records.
  • Performs as a mentor, preceptor, or nurse educator providing didactic and clinical instruction for graduate-level nurse anesthesia students and/or other anesthesia care providers.
  • Recognizes clinical and technical aspects of anesthesia care and has in-depth knowledge of anesthesia methods and techniques for the practice of anesthesia.
  • Practices nurse anesthesia concepts within a team to deliver anesthesia care and blend management skills with technical experience.
  • Applies new developments and theories to develop and demonstrate the ability to recognize and solve various complex anesthesia situations.
  • Effectively blends technology, skills, and competency for the advancement of anesthesia techniques, pharmacology, and equipment.


Pay: Competitive salary, regular salary increases, potential for performance awards

Paid Time Off: 50 days of paid time off per year (26 days of annual leave, 13 days of sick leave, 11 paid Federal holidays per year)

Retirement: Traditional federal pension (5 years vesting) and federal 401K with up to 5% in contributions by VA

Insurance: Federal health/vision/dental/term life/long-term care (many federal insurance programs can be carried into retirement)

Licensure: 1 full and unrestricted license from any US State or territory

Work Schedule: Monday-Friday 7:00am- 3:30pm

Compressed/Flexible: Unavailable

Telework: Unavailable

Virtual: This is not a virtual position.

Recruitment Incentives: Maybe authorized for highly qualified external candidates.

Permanent Change of Station (PCS): Not Authorized

Financial Disclosure Report: Not required

Requirements

Conditions of Employment

  • U.S. Citizenship; non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • All applicants tentatively selected for VA employment in a testing designated position are subject to urinalysis to screen for illegal drug use prior to appointment. Applicants who refuse to be tested will be denied employment with VA.
  • Selective Service Registration is required for males born after 12/31/1959.
  • Must be proficient in written and spoken English.
  • You may be required to serve a probationary period.
  • Subject to background/security investigation.
  • Selected applicants will be required to complete an online onboarding process.
  • Must pass pre-employment physical examination
  • Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP).
  • Participation in the Coronavirus Disease 2019 (COVID-19) vaccination program is a requirement for all Veterans Health Administration Health Care Personnel (HCP) - See "Additional Information" below for details.
  • Note: Must have Basic Life Support (BLS) certification prior to assuming clinical duties.. The BLS requirement is satisfied by successfully completing an American Heart Association (AHA) BLS Healthcare Provider Course or Military Training Network (MTN). BLS courses are normally offered within 1-5 days of entry on duty. No online certifications will be accepted.


Qualifications

Basic Requirements:
  • United States Citizenship: Non-citizens may only be appointed when it is not possible to recruit qualified citizens in accordance with VA Policy.
  • English Language Proficiency. In accordance with 38 U.S.C. 7402(d), no person shall serve in direct patient care positions unless they are proficient in basic written and spoken English.
  • Graduate of a school of professional nursing approved by the appropriate State-accrediting agency and accredited by one of the following accrediting bodies at the time the program was completed by the applicant: The Accreditation Commission for Education in Nursing (ACEN) or The Commission on Collegiate Nursing Education (CCNE). In cases of graduates of foreign schools of professional nursing, possession of current, full, active and unrestricted registration will meet the requirement of graduation from an approved school of professional nursing. OR The completion of coursework equivalent to a nursing degree in a MSN Bridge Program that qualifies for professional nursing registration constitutes the completion of an approved course of study of professional nursing. Students should submit the certificate of professional nursing to sit for the NCLEX to the VA along with a copy of the MSN transcript. (Reference VA Handbook 5005, Appendix G6) OR In cases of graduates of foreign schools of professional nursing, possession of a current, full, active and unrestricted registration will meet the requirement for graduation from an approved school of professional nursing.
  • Current, full, active, and unrestricted registration as a graduate professional nurse in a State, Territory or Commonwealth (i.e., Puerto Rico) of the United States, or the District of Columbia.
  • Certification: On and after May 4, 1993, certification by the Council on Certification of Nurse Anesthetists is a requirement for employment. This requirement does not apply to non-certified nurse anesthetists employed by VA as a nurse anesthetist prior to May 4, 1993 and continuously thereafter. Any nurse anesthetist who leaves VA employment or vacates the nurse anesthetist occupation for another VA position, must meet the current requirement of certification for re-appointment as a nurse anesthetist.

Grade Determinations: In addition to the basic requirements above, all applicants must meet one of the following grade requirements for a specific grade level:

  • Nurse II (Entry Level) - A BSN with approximately 2-3 years of nursing practice/experience; OR ADN or Diploma in Nursing and a Bachelor's degree in a related field and approximately 2-3 years of nursing practice/experience; OR a Master's degree in nursing or related field with a BSN and approximately 1-2 years of nursing practice/experience; OR a Doctoral degree in nursing or meets basic requirements for appointment and has doctoral degree in a related field with no additional nursing practice/experience required.
  • Nurse III (Full Performance Level) - Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience; OR a Doctoral degree and approximately 2-3 years of nursing practice/experience.

Note regarding MSN degrees: If your MSN was obtained via a Bridge Program that qualifies for professional nursing registration, a BSN is not required.

Reference: VA Handbook 5005/37, Part II, Appendix G7 NURSE ANESTHETIST QUALIFICATION STANDARD.

Preferred Experience:

  • Master's degree in nursing or related field with BSN and approximately 2-3 years of nursing practice/experience.
  • OR a Doctoral degree and approximately 2-3 years of nursing practice/experience.


Physical Requirements:

Physical and mental stamina sufficient to diligently monitor the anesthetized patient for prolonged periods of time and have the ability to manage many stressful situations.

Education

IMPORTANT: A transcript must be submitted with your application if you are basing all or part of your qualifications on education.

Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: http://ope.ed.gov/accreditation/. If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: http://www.ed.gov/about/offices/list/ous/international/usnei/us/edlite-visitus-forrecog.html.

Additional information

This job opportunity announcement may be used to fill additional vacancies.

This position is in the Excepted Service and does not confer competitive status.

VA encourages persons with disabilities to apply. The health-related positions in VA are covered by Title 38, and are not covered by the Schedule A excepted appointment authority.

Pursuant to VHA Directive 1193.01, VHA health care personnel (HCP) are required to be fully vaccinated against COVID-19 subject to such accommodations as required by law (i.e., medical, religious or pregnancy). VHA HCPs do not include remote workers who only infrequently enter VHA locations. If selected, you will be required to be fully vaccinated against COVID-19 and submit documentation of proof of vaccination before your start date. The agency will provide additional information regarding what information or documentation will be needed and how you can request a legally required accommodation from this requirement using the reasonable accommodation process.

VA Healthcare System Serving Ohio, Indiana and Michigan (VISN 10) advocates for a Whole Health System of care in each of the Medical Centers. This is an approach to healthcare that empowers and equips people to take charge of their health and well-being and live their lives to the fullest. As an employee operating in a Whole Health System of care, you will operate in a model with three core elements, seeking to create a personalized health plan for each Veteran. This is done in the context of healing relationships and healing environments and a connection back to the Veteran's community. This aligns with the Veterans Health Administration (VHA) Mission Statement to Honor America's Veterans by providing exceptional health care that improves their health and well-being

If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement.

  • Benefits

    A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

    Review our benefits

    Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.


How You Will Be Evaluated

You will be evaluated for this job based on how well you meet the qualifications above.

IN DESCRIBING YOUR EXPERIENCE, PLEASE BE CLEAR AND SPECIFIC. WE MAY NOT MAKE ASSUMPTIONS REGARDING YOUR EXPERIENCE. Your application, resume, C.V., and/or supporting documentation will be verified. Please follow all instructions carefully. Errors or omissions may affect consideration for employment.

NOTE: Candidate's education, scope, and length of nursing practice (experience) will be considered by a Nurse Professional Standards Board in determining the grade and salary of the applicant selected. The recommended salary may be at any point in the range listed for this vacancy.

Experience as an RN will be evaluated to determine if the experience is of an acceptable level of quality with regard to the following four dimensions of nursing: Practice, Professional Development, Collaboration and Scientific Inquiry. Each dimension of practice has criteria that demonstrate essential core competencies for VHA Nursing Personnel.

Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience.

The Department of Veterans Affairs performs pre-employment reference checks as an assessment method used in the hiring process to verify information provided by a candidate (e.g., on resume or during interview or hiring process); gain additional knowledge regarding a candidate's abilities; and assist a hiring manager with making a final selection for a position.

It is the policy of the VA to not deny employment to those that have faced financial hardships or periods of unemployment.

Veterans and Transitioning Service Members: Please visit the VA for Vets site for career-search tools for Veterans seeking employment at VA, career development services for our existing Veterans, and coaching and reintegration support for military service members.

  • Benefits

    A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

    Review our benefits

    Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.
  • Required Documents

    As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.

    To apply for this position, you must provide a complete Application Package which includes:

    • Resume


    The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), etc.

    • Cover Letter
    • DD-214/ Statement of Service
    • Disability Letter (Schedule A)
    • Disability Letter (VA)
    • License
    • OF-306
    • Other (1)
    • Other (2)
    • Other (3)
    • Performance Appraisal
    • Professional Certification
    • Resume
    • Separation Notice (RIF)
    • SF-15
    • SF-50/ Notification of Personnel Action
    • Transcript


    VA Form 10-2850a - Application for Nurses and Nurse Anesthetists can be found at: About VA Form 10-2850A | Veterans Affairs.

    Veterans' Preference Note: Preference eligible candidates and other Veterans will be given preference when qualification of candidates are approximately equal for Title 38 positions in VHA. When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.


    If you are relying on your education to meet qualification requirements:


    Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from
    schools accredited by accrediting institutions recognized by the U.S. Department of Education.

    Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.
  • How to Apply

    All applicants are encouraged to apply online. To apply for this position, you must complete the full questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 06/03/2024 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12158505.
    1. To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.
    2. Click Submit My Answers to submit your application package.


    NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.

    To verify your application is complete, log into your USA JOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.

    Agency contact information



    Brian Oliver


    Phone

    734-934-0217

    Email

    Brian.Oliver2@va.gov

    Address

    Ann Arbor VA Medical Center

    2215 Fuller Road

    Ann Arbor, MI 48105

    US

    Next steps

    Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.

    You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.

    NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.
  • Fair and Transparent

    The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

    • Equal Employment Opportunity (EEO) Policy
    • Reasonable accommodation policy
    • Financial suitability
    • Selective Service
    • New employee probationary period
    • Signature and false statements
    • Privacy Act
    • Social security number request


Required Documents

To apply for this position, you must provide a complete Application Package which includes:

  • Resume


The following documents are accepted, and may be required if applicable to your eligibility and/or qualifications for this position. Please use this checklist to ensure you have included all documents required for your application, such as a copy of your transcript (if using education to qualify), SF-50's (current/former Federal employees), etc.

  • Cover Letter
  • DD-214/ Statement of Service
  • Disability Letter (Schedule A)
  • Disability Letter (VA)
  • License
  • OF-306
  • Other (1)
  • Other (2)
  • Other (3)
  • Performance Appraisal
  • Professional Certification
  • Resume
  • Separation Notice (RIF)
  • SF-15
  • SF-50/ Notification of Personnel Action
  • Transcript


VA Form 10-2850a - Application for Nurses and Nurse Anesthetists can be found at: About VA Form 10-2850A | Veterans Affairs.

Veterans' Preference Note: Preference eligible candidates and other Veterans will be given preference when qualification of candidates are approximately equal for Title 38 positions in VHA. When applying for Federal Jobs, eligible Veterans should claim preference for 5pt (TP), 10pt (CP/CPS/XP), or for Sole Survivor Preference (SSP) in the questionnaire. You must provide a legible copy of your DD214(s) which shows dates and character of service (honorable, general, etc.). If you are currently serving on active duty and expect to be released or discharged within 120 days you must submit documentation related to your active duty service which reflects the dates of service, character of service (honorable, general, etc.), and dates of impending separation. Additionally, disabled veterans and others eligible for 10-point preference (such as widows or mothers of eligible Veterans) must also submit an SF-15 "Application for 10 Point Veteran Preference" with required proof as stated on the form. Documentation is required to award preference. For more information on Veterans' Preference, please visit Feds Hire Vets - Veterans - Job Seekers - Veterans' Preference.


If you are relying on your education to meet qualification requirements:


Education must be accredited by an accrediting institution recognized by the U.S. Department of Education in order for it to be credited towards qualifications. Therefore, provide only the attendance and/or degrees from
schools accredited by accrediting institutions recognized by the U.S. Department of Education.

Failure to provide all of the required information as stated in this vacancy announcement may result in an ineligible rating or may affect the overall rating.

How to Apply

All applicants are encouraged to apply online. To apply for this position, you must complete the full questionnaire and submit the documentation specified in the Required Documents section below. The complete application package must be submitted by 11:59 PM (ET) on 06/03/2024 to receive consideration. To preview the questionnaire click https://apply.usastaffing.gov/ViewQuestionnaire/12158505.
  1. To begin, click Apply Online to create a USAJOBS account or log in to your existing account. Follow the prompts to select your USA JOBS resume and/or other supporting documents and complete the occupational questionnaire.
  2. Click Submit My Answers to submit your application package.


NOTE: It is your responsibility to ensure your responses and appropriate documentation is submitted prior to the closing date.

To verify your application is complete, log into your USA JOBS account, https://my.usajobs.gov/Account/Login, select the Application Status link and then select the more information link for this position. The Details page will display the status of your application, the documentation received and processed, and any correspondence the agency has sent related to this application. Your uploaded documents may take several hours to clear the virus scan process. To return to an incomplete application, log into your USA JOBS account and click Update Application in the vacancy announcement. You must re-select your resume and/or other documents from your USA JOBS account or your application will be incomplete.

Agency contact information



Brian Oliver


Phone

734-934-0217

Email

Brian.Oliver2@va.gov

Address

Ann Arbor VA Medical Center

2215 Fuller Road

Ann Arbor, MI 48105

US

Next steps

Once your online application is submitted you will receive a confirmation notification by email. After we receive application packages (including all required documents) and the vacancy announcement closes, we will review applications to ensure qualification and eligibility requirements are met. After the review is complete, a referral certificate(s) is issued and applicants will be notified of their status by email. Referred applicants will be notified as such and may be contacted directly by the hiring office for an interview. All referred applicants receive a final notification once a selection decision has been made.

You may check the status of your application at any time by logging into your USA Jobs account and clicking on Applications. Information regarding your application status can be found in the USAJobs Help Center.

NOTE: Participation in the seasonal influenza program is a condition of employment and a requirement for all Department of Veterans Affairs Health Care Personnel (HCP). It is a requirement that all HCP to receive annual seasonal influenza vaccination or obtain an exemption for medical or religious reasons. Wearing a face mask is required when an exemption to the influenza vaccination has been granted. HCP in violation of this directive may face disciplinary action up to and including removal from federal service. HCP are individuals who, during the influenza season, work in VHA locations or who come into contact with VA patients or other HCP as part of their duties. VHA locations include, but are not limited to, VA hospitals and associated clinics, community living centers (CLCs), community-based outpatient clinics (CBOCs), domiciliary units, Vet centers and VA-leased medical facilities. HCP include all VA licensed and unlicensed, clinical and administrative, remote and onsite, paid and without compensation, full- and part-time employees, intermittent employees, fee basis employees, VA contractors, researchers, volunteers and health professions trainees (HPTs) who are expected to perform any or all of their work at these facilities. HPTs may be paid or unpaid and include residents, interns, fellows and students. HCP also includes VHA personnel providing home-based care to Veterans and drivers and other personnel whose duties put them in contact with patients outside VA medical facilities.

Fair & Transparent

The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

  • Equal Employment Opportunity (EEO) Policy
  • Reasonable accommodation policy
  • Financial suitability
  • Selective Service
  • New employee probationary period
  • Signature and false statements
  • Privacy Act
  • Social security number request

Created: 2024-04-16
Reference: 755785600
Country: United States
State: Michigan
City: Ann Arbor
ZIP: 48103


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