Individual
DR. JACKSON TATE NORDBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4015 S ARIZONA AVE STE C2, CHANDLER, AZ 85248-4586
(480) 426-8019
Mailing address
4630 S LAKESHORE DR APT 230, TEMPE, AZ 85282-7175
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501303745
MI
225100000X
Physical Therapist
Primary
LPT-034190
AZ
Other
Enumeration date
06/26/2025
Last updated
09/03/2025
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