Provider Demographics
NPI:1104022722
Name:STRETCH TO WIN
Entity type:Organization
Organization Name:STRETCH TO WIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:FREDERICK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:480-394-0440
Mailing Address - Street 1:2525 S RURAL RD STE 4N
Mailing Address - Street 2:
Mailing Address - City:TEMPE
Mailing Address - State:AZ
Mailing Address - Zip Code:85282-2442
Mailing Address - Country:US
Mailing Address - Phone:480-394-0440
Mailing Address - Fax:480-394-0441
Practice Address - Street 1:2525 S RURAL RD STE 4N
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85282-2442
Practice Address - Country:US
Practice Address - Phone:480-394-0440
Practice Address - Fax:480-394-0441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty