Provider Demographics
NPI:1598087546
Name:PIERSAK, DAVID (LAB TECH)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:PIERSAK
Suffix:
Gender:M
Credentials:LAB TECH
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 6TH AVE NORTH
Mailing Address - Street 2:
Mailing Address - City:WOLF POINT
Mailing Address - State:MT
Mailing Address - Zip Code:59201
Mailing Address - Country:US
Mailing Address - Phone:406-653-1641
Mailing Address - Fax:406-653-3728
Practice Address - Street 1:550 6TH AVE NORTH
Practice Address - Street 2:
Practice Address - City:WOLF POINT
Practice Address - State:MT
Practice Address - Zip Code:59201
Practice Address - Country:US
Practice Address - Phone:406-653-1641
Practice Address - Fax:406-653-3728
Is Sole Proprietor?:No
Enumeration Date:2010-02-18
Last Update Date:2010-02-18
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist