# CLOVIS SURGERY CENTER NM LLC

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

## Provider details

- **NPI number:** 1912512542
- **Authorized official:** 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
- **Practice address fax:** (575) 935-3669
- **Mailing address:** 921 E 21ST ST STE C, CLOVIS, NM 88101-4443
- **Mailing address phone:** (575) 935-3668

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | NULL | Yes |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/10/2020
- **Last updated:** 09/10/2020