Individual
NTOZAKE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
135 APPLE AVE, BENTON HARBOR, MI 49022-4901
(269) 944-7029
Mailing address
135 APPLE AVE, BENTON HARBOR, MI 49022-4901
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703101702
MI
Other
Enumeration date
06/14/2023
Last updated
06/15/2023
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