Individual
NICOLE MARIE COWART
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFM
Contact information
Practice address
500 WASHINGTON ST, THE DALLES, OR 97058-2217
(541) 370-2350
Mailing address
PO BOX 746, THE DALLES, OR 97058-0746
(541) 370-5640
Taxonomy
Speciality
Code
Description
License number
State
224900000X
Mastectomy Fitter
Primary
CFM01332
DE
Other
Enumeration date
04/10/2020
Last updated
04/10/2020
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