Organization
WHITE MOUNTAIN CHIROPRACTIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE WAYNE KLINEKOLE III D.C., DACNB (PRESIDENT)
(575) 257-7970
Entity
Organization
Contact information
Practice address
500 MECHEM DR, SUITE C, RUIDOSO, NM 88345-6949
(575) 257-7970
(575) 257-7970
Mailing address
500 MECHEM DR, SUITE C, RUIDOSO, NM 88345-6949
(575) 257-7970
(575) 257-7970
Taxonomy
Speciality
Code
Description
License number
State
111NN0400X
Neurology Chiropractor
Primary
1375
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
585929590
MEDICARE PTAN
NM
05
—
L4208
—
NM
Enumeration date
09/10/2012
Last updated
10/16/2013
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