Organization Name: | SANFORD MEDICAL CENTER FARGO |
NPI Number: | 1366722647 |
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: | |
NPI Enumeration Date: | 08/18/2011 |
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 |