Organization
SANFORD MEDICAL CENTER FARGO
Active
Other names
Sanford Health Detroit Lakes Eye Center & Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MARTHA LECLERC (VICE PRESIDENT)
(701) 234-6248
Entity
Organization
Contact information
Practice address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Mailing address
1245 WASHINGTON AVE, DETROIT LAKES, MN 56501-3905
(218) 846-2000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
332H00000X
Eyewear Supplier
—
—
Other
Enumeration date
08/18/2011
Last updated
08/18/2011
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