White Crane Clinic, P.a.
NPI #1356417711 in Taos, New Mexico
Provider Information
- NPI Number
- 1356417711
- Entity Type
- Organization
- Organization Name
- White Crane Clinic, P.a.
- Primary Specialty
- Clinic/Center
- Enumeration Date
- Nov 28, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 1332 GUSDORF RD
- Address 2
- STE. E
- City
- Taos
- State
- New Mexico
- ZIP Code
- 87571-6371
- Phone
- (505) 758-2700
Authorized Official
- Name
- DR. CARL EUGENE WAGNER, D.O.M.
- Title
- PRESIDENT
- Phone
- (505) 758-2700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center |
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