Organization
WHITE CRANE CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL EUGENE WAGNER D.O.M. (PRESIDENT)
(505) 758-2700
Entity
Organization
Contact information
Practice address
1332 GUSDORF RD, STE. E, TAOS, NM 87571-6371
(505) 758-2700
(505) 758-2700
Mailing address
1332 GUSDORF RD, STE. E, TAOS, NM 87571-6371
(505) 758-2700
(505) 758-2700
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
11/28/2006
Last updated
08/22/2020
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