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1174000566
TIMOTHY WAYNE CORK
COEUR D ALENE, ID
NPI
1174000566
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
174400000X Specialist
Enumeration Date
2018-07-27
Last Update Date
2018-07-27
Business Address
TIMOTHY WAYNE CORK CPRP, BS
2201 IRONWOOD PL
COEUR D ALENE, ID 83814-2670
Phone number: 208-769-4222
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Mailing Address
TIMOTHY WAYNE CORK CPRP, BS
2201 IRONWOOD PL
COEUR D ALENE, ID 83814-2670
Phone number: 208-769-4222
Copy
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