Provider Demographics
NPI:1467159137
Name:STRIDE CHIROSPORT
Entity Type:Organization
Organization Name:STRIDE CHIROSPORT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:
Authorized Official - Last Name:ACADEMIA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:214-663-4621
Mailing Address - Street 1:1400 N COIT RD STE 901
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-6659
Mailing Address - Country:US
Mailing Address - Phone:214-799-1161
Mailing Address - Fax:
Practice Address - Street 1:1400 N COIT RD STE 901
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-6659
Practice Address - Country:US
Practice Address - Phone:214-799-1161
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-13
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center