Individual
JASON P CORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ADRN
Contact information
Practice address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
(608) 785-6266
Mailing address
1407 SAINT ANDREW ST STE 100, LA CROSSE, WI 54603-2378
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
167070-30
WI
Other
Enumeration date
04/20/2012
Last updated
04/20/2012
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