Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Rural Health |
261QR1300X | B4[14] | Rural Health Clinic |
| NPI # | 1780690305 |
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| LBN Legal business name | SANFORD CLINIC NORTH | ||||||||||||||||
| Authorized official | MARTH LECLERC - (VP) | ||||||||||||||||
| Entity | Organization | ||||||||||||||||
| Organization subpart 1 | No | ||||||||||||||||
| Enumeration date | 08/01/2006 | ||||||||||||||||
| Last updated | 11/27/2023 - About 3 years ago | ||||||||||||||||
| Identifiers |
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