Individual
WILLIAM JACOB WAHLERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3825 EUBANK BLD NE STE C, ALBUQUERQUE, NM 87111-3591
(505) 298-8020
(505) 292-5006
Mailing address
3825 EUBANK BLVD NE, STE C, ALBUQUERQUE, NM 87111-3591
(505) 298-8020
(505) 237-8803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
88PA17
NM
Other
Enumeration date
11/14/2005
Last updated
01/21/2011
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