Organization
WHITE MOUNTAIN CHIROPRACTIC INC.
Active
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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