Organization
GUADALUPE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL CORMIER (OWNER)
(480) 926-7800
Entity
Organization
Contact information
Practice address
1855 E GUADALUPE RD STE 112, TEMPE, AZ 85283-3269
(480) 839-8552
(480) 926-2260
Mailing address
4432 N MILLER RD STE 102, SCOTTSDALE, AZ 85251-3697
(480) 306-7227
(480) 306-7238
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
225100000X
Physical Therapist
—
—
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/14/2018
Last updated
02/12/2024
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