| T Wiard Llc | |
|
125 La Posta Rd Ste B15 Taos NM 87571-7242 | |
| (505) 690-0126 | |
| Not Available |
| Full Name | T Wiard Llc |
|---|---|
| Speciality | Counselor - Professional |
| Location | 125 La Posta Rd Ste B15, Taos, New Mexico |
| Authorized Official Name and Position | Theodore John Wiard (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5056900126 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| T Wiard Llc Post Office Box 569 Arroyo Hondo NM 87513 Ph: (505) 690-0126 | T Wiard Llc 125 La Posta Rd Ste B15 Taos NM 87571-7242 Ph: (505) 690-0126 |
| NPI Number | 1942637517 |
|---|---|
| Provider Enumeration Date | 09/27/2013 |
| Last Update Date | 06/06/2024 |
| Certification Date | 06/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942637517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0109811 (New Mexico) | Primary |
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