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1225503501
AUDRA LOU KUPERUS
GRAND RAPIDS, MI
NPI
1225503501
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: MI 5202008414)
Enumeration Date
2018-10-12
Last Update Date
2020-02-13
Business Address
AUDRA LOU KUPERUS COTAL
3600 FULTON ST E
GRAND RAPIDS, MI 49546-1322
Phone number: 616-949-4971
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Mailing Address
AUDRA LOU KUPERUS COTAL
6351 N BROADWAY RD
FREEPORT, MI 49325-9712
Phone number: 616-212-9216
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