Individual
KEVIN COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
350 LAFAYETTE AVE SE SUITE 500, GRAND RAPIDS, MI 49503
(616) 840-8684
Mailing address
645 BROADVIEW ST. SE, GRAND RAPIDS, MI 49507
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201010130
MI
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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