Provider Demographics
NPI:1215769856
Name:ALSPAUGH, COOPER
Entity type:Individual
Prefix:
First Name:COOPER
Middle Name:
Last Name:ALSPAUGH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11657 S FOREST HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAGLE
Mailing Address - State:MI
Mailing Address - Zip Code:48822-9722
Mailing Address - Country:US
Mailing Address - Phone:517-648-1551
Mailing Address - Fax:
Practice Address - Street 1:13105 SCHAVEY RD STE 5
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-9014
Practice Address - Country:US
Practice Address - Phone:517-853-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501303486225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist