Individual
DR. ROBERT CORY FANTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
800 WEST MAPLE STREET, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(505) 565-7015
Mailing address
800 WEST MAPLE STREET, P O BOX 800, MEDICAL LAKE, WA 99022-0800
(509) 565-4000
(505) 565-7015
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY60127865
WA
Other
Enumeration date
04/08/2010
Last updated
04/08/2010
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