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Individual

JESSICA KEELER TATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT, OCS

Contact information

Practice address
20830 N TATUM BLVD, SUITE 115, PHOENIX, AZ 85050-7256
(480) 473-1200
(480) 473-1250
Mailing address
20940 N TATUM BLVD, SUITE B-200, PHOENIX, AZ 85050-4265
(602) 483-1710
(480) 272-7793

Taxonomy

Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
10215
AZ
2251X0800X
Orthopedic Physical Therapist
38629
CA

Other

Enumeration date
02/08/2012
Last updated
10/02/2015
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