Individual
DR. MICHAEL DALE WIDENER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DN
Contact information
Practice address
1713 SUDDERTH DR, RUIDOSO, NM 88345-6114
(575) 315-2367
(575) 315-2925
Mailing address
103 EL PASO RD, RUIDOSO, NM 88345-6033
(575) 973-1514
Taxonomy
Speciality
Code
Description
License number
State
172P00000X
Naprapath
Primary
1029
NM
Other
Enumeration date
08/16/2023
Last updated
06/06/2024
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