-- DANIELLE CORK --
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1821477969- Provider Type
- Individual Provider (NPI-1)
- Status
- Active
Contact & Location
- Address
- 1501 HARTFORD ST, LAFAYETTE, IN, 479042134
- Phone
- (765) 428-5850
- Fax
- (765) 428-5851
Specialties & Taxonomies
Physician Assistant
Primary License: IN #10001791A