Cork, Timothy Wayne

Cork, Timothy Wayne is an individual health care provider with primary practice located at 2201 Ironwood Pl , Coeur D Alene ID 83814-2670. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Cork, Timothy Wayne can be contacted via phone (208) 769-4222.

Contact Information

Primary practice address
2201 Ironwood Pl Coeur D Alene ID 83814-2670
Fax: (208) 771-0628
Website:

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1174000566
LBN Legal business name Cork, Timothy Wayne
Credentials CPRP, BS
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 27th, 2018
Last updated Jul 27th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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