Organization
JG SANFORD LLC
Active
Other names
Physician's Optical
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EARLE GLENN SANFORD M.D. (MANAGING PARTNER)
(660) 885-8171
Entity
Organization
Contact information
Practice address
1602 N 2ND ST, CLINTON, MO 64735
(660) 885-2020
(660) 885-9375
Mailing address
1602 N 2ND ST, CLINTON, MO 64735
(660) 885-2020
(660) 885-9375
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
LC0010929
MO
Other
Enumeration date
10/06/2006
Last updated
05/01/2019
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