Individual
MRS. BETHANY COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1224 JEFFREY LN, CHARLEVOIX, MI 49720-8968
(231) 547-4003
Mailing address
1224 JEFFREY LN, CHARLEVOIX, MI 49720-8968
(231) 547-4003
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/15/2016
Last updated
03/15/2016
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