Mesa Outpatient Treatment Center LLC

NPI #1316468333 in Mesa, Arizona

Provider Information

NPI Number: 1316468333
Entity Type: Organization
Organization Name: Mesa Outpatient Treatment Center LLC
Primary Specialty: Surgery
Enumeration Date: Jun 29, 2017
Last Updated: Jul 21, 2022

Practice Location

Address: 4540 E BASELINE RD STE 119
City: Mesa
State: Arizona
ZIP Code: 85206
Phone: (480) 272-8944

Authorized Official

Name: JEREMY BUCKNER, DC
Title: MBR
Phone: (480) 272-8944

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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