GEORGE MARK CORAM

PRESCOTT, AZ
NPI1245348408
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy133V00000X Dietitian, Registered
(Licence: IL  11982)
Enumeration Date2006-08-28
Last Update Date2007-07-08
Business Address
Mr. GEORGE MARK CORAM RD
NAVAHCS 500 N HWY 89
PRESCOTT, AZ 86313
Phone number: 928-445-4860
Mailing Address
Mr. GEORGE MARK CORAM RD
11850 E ARABIAN LN
DEWEY, AZ 86327-6001
Phone number: 928-445-4860
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