# CALGARY MEDICAL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740601962
- **Authorized official:** JEREMY BUCKNER DC (MANAGER)
- **Authorized official phone:** (602) 889-5833

## Contact information

- **Practice address:** 4540 E BASELINE RD, SUITE 105, MESA, AZ 85206-4613
- **Practice address phone:** (480) 272-8944
- **Practice address fax:** (480) 237-5682
- **Mailing address:** 4540 E BASELINE RD, SUITE 105, MESA, AZ 85206-4613
- **Mailing address phone:** (480) 272-8944
- **Mailing address fax:** (480) 237-5682

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | Yes |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | — | — | Yes |

## Other

- **Enumeration date:** 12/16/2013
- **Last updated:** 12/16/2013