Healthcare Provider Details

I. General information

NPI: 1467393983
Provider Name (Legal Business Name): DEAN JACKSON PITCHING TRAINING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2026
Last Update Date: 04/01/2026
Certification Date: 04/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21602 N CENTRAL AVE STE 6
PHOENIX AZ
85024-5106
US

IV. Provider business mailing address

13213 N 69TH ST
SCOTTSDALE AZ
85254-4002
US

V. Phone/Fax

Practice location:
  • Phone: 602-540-7664
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: DEAN JACKSON
Title or Position: OWNER
Credential:
Phone: 602-540-7664