Individual
MRS. JANICE MARIE DIFELICE COOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.
Contact information
Practice address
176 SMITH CREEK RD, PRAIRIE, ID 83647-8442
(208) 631-0578
Mailing address
176 SMITH CREEK RD, PRAIRIE, ID 83647-8442
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
MIDGM30
ID
Other
Enumeration date
02/17/2011
Last updated
02/17/2011
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