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Organization
BACK AND NECK MEDICAL CARE CENTER, LLC
Active
Organization
BACK AND NECK MEDICAL CARE CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN J. WALDT DO (PROVIDER OWNER)
(505) 695-1227
Entity
Organization
Contact information
Practice address
2803 DORAL CT, LAS CRUCES, NM 88011-8616
(046) 984-4063
(877) 532-2113
Mailing address
1180 COMMERCE DR UNIT 14222, LAS CRUCES, NM 88013-4649
(505) 695-1227
(877) 532-2113
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
04/29/2021
Last updated
05/08/2024
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