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
—
—
Other
Enumeration date
04/29/2021
Last updated
05/08/2024
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