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Individual

DAVID PECORA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3216
(218) 335-3204
Mailing address
425 7TH ST NW, CASS LAKE, MN 56633-3360
(218) 335-3216
(218) 335-3204

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103061
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
410684900
MN
01
995N6PE
BCBSM
MN
Enumeration date
12/20/2006
Last updated
07/08/2007
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