Individual
CHRISTINE E CORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C CAQ PSYCH
Contact information
Practice address
635 GOOSEBERRY DR UNIT 1905, LONGMONT, CO 80503-6457
(678) 697-9665
Mailing address
635 GOOSEBERRY DR UNIT 1905, LONGMONT, CO 80503-6457
(678) 697-9665
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
PA.0005295
CO
363A00000X
Physician Assistant
Primary
PA.0005295
CO
Other
Enumeration date
12/20/2017
Last updated
02/15/2024
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