Organization
SAGE HEALTHCARE 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
20325 N 51ST AVE STE 102, GLENDALE, AZ 85308-5665
(480) 930-4018
Mailing address
PO BOX 11180, TEMPE, AZ 85284-0020
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
—
—
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
02/07/2020
Last updated
07/09/2020
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