Individual
AUDREY COOPER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
22560 130TH AVE, TUSTIN, MI 49688-8565
(231) 206-1626
Mailing address
22560 130TH AVE, TUSTIN, MI 49688-8565
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/03/2021
Last updated
10/28/2025
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