Bryan P Pucik MD

NPI 1073592077 - Family Medicine - 207Q00000X

NPI Details
NPI 1073592077
Gender Male
Enumeration Date 01/10/2006
Last Updated 10/21/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
1230 E. MAIN STREET
MANKATO CLINIC @ MAIN STREET
MANKATO MN, 56002-8674, US
Phone (507) 625-1811
Fax
Business Location
PO BOX 8674 1230 E. MAIN STREET
MANKATO CLINIC, LTD
MANKATO MN, 56002-8674, US
Phone (507) 625-1811
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Wisconsin
License Number 53516
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According to our database, Bryan P Pucik MD NPI is 1073592077, taxonomy code is 207Q00000X and license number is 53516, license state is located at Wisconsin. Bryan P Pucik MD physically located at 1230 E. Main Street, Mankato MN, 56002-8674. NPI Number Bryan P Pucik MD has the Individual type.

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1073592077 NPI number is provided on an as is basis without warranty of any kind. 1073592077 is maintained by the National Plan & Provider Enumeration System. The contents of Bryan P Pucik MD are for informational purposes only.