Individual
JEREMY RAY BUCKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4540 E BASELINE RD STE 105, MESA, AZ 85206-4616
(480) 819-0393
(480) 536-9170
Mailing address
PO BOX 11180, TEMPE, AZ 85284-0020
(480) 897-3300
(480) 897-3312
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7490
AZ
111NR0400X
Rehabilitation Chiropractor
4180
AZ
Other
Enumeration date
01/16/2006
Last updated
11/10/2020
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