| Tdcrotinger | |
|
205 Park Ave Raton NM 87740-3834 | |
| (575) 303-3500 | |
| (888) 972-3649 |
| Full Name | Tdcrotinger |
|---|---|
| Speciality | Counselor - Professional |
| Location | 205 Park Ave, Raton, New Mexico |
| Authorized Official Name and Position | Terry D Crotinger (GROUP OF 1) |
| Authorized Official Contact | 5753033500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tdcrotinger Po Box 1396 Raton NM 87740-1396 Ph: (575) 303-3500 | Tdcrotinger 205 Park Ave Raton NM 87740-3834 Ph: (575) 303-3500 |
| NPI Number | 1083001002 |
|---|---|
| Provider Enumeration Date | 04/16/2015 |
| Last Update Date | 04/16/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1083001002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 0159381 (New Mexico) | Primary |
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