Timothy Wayne Cork, CPRP, BS
NPI #1174000566 in Coeur D Alene, Idaho
Provider Information
- NPI Number
- 1174000566
- Entity Type
- Individual
- Name
- Timothy Wayne Cork, CPRP, BS
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Credential
- CPRP, BS
- Enumeration Date
- Jul 27, 2018
- Last Updated
- Jul 27, 2018
Practice Location
- Address
- 2201 IRONWOOD PL
- City
- Coeur D Alene
- State
- Idaho
- ZIP Code
- 83814-2670
- Phone
- (208) 769-4222
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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