Individual
RYAN KINDRED CORK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5776 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32207-8046
(904) 801-9560
Mailing address
5776 SAINT AUGUSTINE RD, JACKSONVILLE, FL 32207-8046
(904) 801-9560
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
AK
171M00000X
Case Manager/Care Coordinator
Primary
—
FL
Other
Enumeration date
09/24/2020
Last updated
03/24/2025
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