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Organization
SANFORD CLINIC NORTH
Active
Organization
SANFORD CLINIC NORTH
Active
Other names
Perham Health New York Mills Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA K LECLERC (VP)
(701) 234-6248
Entity
Organization
Contact information
Practice address
20 W CENTENNIAL 84 DRIVE, NEW YORK MILLS, MN 56567-0364
(218) 385-1800
(218) 385-1830
Mailing address
PO BOX D, 20 W CENTENNIAL 84 DRIVE, NEW YORK MILLS, MN 56567-0364
(218) 385-1800
(218) 385-1830
Taxonomy
Speciality
Code
Description
License number
State
152WC0802X
Corneal and Contact Management Optometrist
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
463217600
—
MN
Enumeration date
07/25/2006
Last updated
11/07/2011
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