| Organization Name: | SANFORD CLINIC NORTH |
| NPI Number: | 1891045969 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARTHA K LECLERC (VICE PRESIDENT) |
| Mailing Address: | 929 Central Ave Nw East Grand Forks |
| State: | MN US |
| Postal Code: | 567211917 |
| Phone Number: | 2187736800 |
| Fax Number: | |
| NPI Enumeration Date: | 09/14/2012 |
| NPI Last Update Date: | 09/14/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0208X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Radiology, Mobile |
| Taxonomy Definition: | |