Provider Information for 1043444953
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Ms. MONIQUE L ROURK
Sex: Female
NPI: 1043444953
Last Updated: 2013-03-19
Certification Date:
Certification Date:
Details
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NPI | 1043444953 | ||||||||
Enumeration Date | 2009-05-06 | ||||||||
NPI Type | NPI-1 Individual | ||||||||
Sole Proprietor | NO | ||||||||
Status | Active | ||||||||
Mailing Address | 402 S 4TH AVE YAKIMA, WA 98902-3546 United States Phone: 509-575-4084 | Fax: | ||||||||
Primary Practice Address | 402 S 4TH AVE YAKIMA, WA 98902-3546 United States Phone: 509-575-4084 | Fax: | ||||||||
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