# CLOVIS SURGERY CENTER LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427622414
- **Authorized official:** DR. DEVIN WAHLEN DPM (OWNER)
- **Authorized official phone:** (575) 935-3668

## Contact information

- **Practice address:** 1820 W 21ST ST, CLOVIS, NM 88101-4024
- **Practice address phone:** (575) 935-3668
- **Mailing address:** 1820 W 21ST ST, CLOVIS, NM 88101-4024

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QA1903X | Ambulatory Surgical Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/14/2021
- **Last updated:** 09/24/2021