TIMOTHY WAYNE CORK

COEUR D ALENE, ID
NPI1174000566
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy174400000X Specialist
Enumeration Date2018-07-27
Last Update Date2018-07-27
Business Address
TIMOTHY WAYNE CORK CPRP, BS
2201 IRONWOOD PL
COEUR D ALENE, ID 83814-2670
Phone number: 208-769-4222
Mailing Address
TIMOTHY WAYNE CORK CPRP, BS
2201 IRONWOOD PL
COEUR D ALENE, ID 83814-2670
Phone number: 208-769-4222
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