Individual
PETER STASICA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2200 UNIVERSITY AVE W, #114, SAINT PAUL, MN 55114-1839
(651) 644-5800
Mailing address
1320 103RD LN NW, COON RAPIDS, MN 55433-7115
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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