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Individual

BREA COOPER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS, PTA

Contact information

Practice address
2420 COIT AVE NE, GRAND RAPIDS, MI 49505-4001
(616) 604-0451
Mailing address
938 N BOSSETT RD, RAVENNA, MI 49451-9545
(231) 286-9616

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502001804
MI

Other

Enumeration date
03/22/2022
Last updated
03/22/2022
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