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General NPI Number Information
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NPI Number | 1093720864
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Entity Type | Individual
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Provider Name | BRUCE WAYNE KLINEKOLE D.C., D.A.C.N.B.
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Gender | Male
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Dates
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Enumeration Date | 07/30/2006
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 500 MECHEM DR STE B
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City | RUIDOSO
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State | NM
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Zip | 88345-6950
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Country | US
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Telephone | 575-257-7970
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Fax | 575-257-9677
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Provider Business Mailing Address
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Address Line | 500 MECHEM DR STE B
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City | RUIDOSO
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State | NM
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Zip | 88345-6950
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Country | US
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Telephone | 575-257-7970
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Fax | 575-257-9677
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 1375
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 111NN0400X
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Taxonomy Name | Neurology Chiropractor
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License Number | 1375
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License Number State | NM
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