Provider Demographics
NPI:1578606323
Name:LONGMUIR, GARY ANDREW (DC, DACBR)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:ANDREW
Last Name:LONGMUIR
Suffix:
Gender:M
Credentials:DC, DACBR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8540 E MCDOWELL RD
Mailing Address - Street 2:LOT # 51
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-1429
Mailing Address - Country:US
Mailing Address - Phone:480-924-3864
Mailing Address - Fax:
Practice Address - Street 1:1110 E MISSOURI AVE
Practice Address - Street 2:SUITE 395
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-2707
Practice Address - Country:US
Practice Address - Phone:602-274-3331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4044111NR0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NR0200XChiropractic ProvidersChiropractorRadiology