Individual
GRACE COOLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6351 LEYLAND PINE ST, PORTAGE, MI 49024-9049
(269) 270-9185
Mailing address
6351 LEYLAND PINE ST, PORTAGE, MI 49024-9049
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005592
MI
Other
Enumeration date
02/15/2022
Last updated
02/15/2022
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