| Organization Name: | SANFORD CLINIC NORTH |
| NPI Number: | 1154343176 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARTHA K LECLERC (VP) |
| Mailing Address: | 20 W Centennial 84 Drive New York Mills |
| State: | MN US |
| Postal Code: | 565670364 |
| Phone Number: | 2183851800 |
| Fax Number: | 2183851830 |
| NPI Enumeration Date: | 07/25/2006 |
| NPI Last Update Date: | 11/07/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 152WC0802X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Eye and Vision Services Providers |
| Taxonomy Classification: | Optometrist |
| Taxonomy Specialization: | Corneal and Contact Management |
| Taxonomy Definition: | The professional activities performed by an Optometrist related to the fitting of contact lenses to an eye, ongoing evaluation of the cornea |