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1255937520
CARLISSA SIMONE COOPER
BINGHAM FARMS, MI
NPI
1255937520
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
156F00000X Technician/Technologist
Enumeration Date
2020-12-10
Last Update Date
2020-12-10
Business Address
CARLISSA SIMONE COOPER
32100 TELEGRAPH RD
BINGHAM FARMS, MI 48025-2452
Phone number: 248-712-4266
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Mailing Address
CARLISSA SIMONE COOPER
32100 TELEGRAPH RD STE 205
BINGHAM FARMS, MI 48025-2454
Phone number: 248-712-4266
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