Individual
DR. TARA JALAYNE COOPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
400 BROWN RD, AUBURN HILLS, MI 48326-1305
(248) 648-0012
Mailing address
509 HIGHLAND DR, MARSHALLTOWN, IA 50158-5525
(641) 752-5700
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
002435
IA
152W00000X
Optometrist
Primary
4901005105
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1780844886
BLUE CROSS BLUE SHIELD
IA
05
—
1780844886
—
IA
Enumeration date
06/11/2008
Last updated
12/30/2022
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