Organization
WEST PHOENIX SURGICAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEREMY BUCKNER DC (SOLE MEMBER)
(480) 930-4018
Entity
Organization
Contact information
Practice address
9250 W THOMAS RD STE 220, PHOENIX, AZ 85037-3382
(480) 930-4018
Mailing address
4765 S LAKESHORE DR, TEMPE, AZ 85282-7197
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/17/2019
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