Individual
MRS. HEATHER FAYE DESPRES COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1840 WEALTHY ST SE FL 5, GRAND RAPIDS, MI 49506-2921
(616) 774-3833
Mailing address
1018 32ND ST SW, WYOMING, MI 49509-2806
(616) 498-9364
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501006545
MI
Other
Enumeration date
05/15/2018
Last updated
05/15/2018
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