| NPI | 1265712566 |
|---|---|
| Doing Business As | SANFORD BROADWAY MEDICAL BUILDING |
| Entity Type | Organization |
| Authorized Contact | MARTHA K LECLERC VP 701-234-6248 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RI0200X Internal Medicine, Infectious Disease |
| Additional Taxonomies | 111N00000X Chiropractor |
| 133V00000X Dietitian, Registered | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2023-11-27 |