Organization
CLOVIS SURGERY CENTER NM LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEVIN WAHLEN DPM (OWNER)
(575) 935-3668
Entity
Organization
Contact information
Practice address
1820 W 21ST ST, CLOVIS, NM 88101-4024
(575) 935-3668
(575) 935-3669
Mailing address
921 E 21ST ST STE C, CLOVIS, NM 88101-4443
(575) 935-3668
Taxonomy
Speciality
Code
Description
License number
State
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
—
—
Other
Enumeration date
09/10/2020
Last updated
09/10/2020
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