Provider Demographics
NPI:1245096072
Name:STRETCH ZONE FISHERS LLC
Entity type:Organization
Organization Name:STRETCH ZONE FISHERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:SPENCER
Authorized Official - Middle Name:C
Authorized Official - Last Name:TEETER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-827-6833
Mailing Address - Street 1:11398 OLIO RD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-7605
Mailing Address - Country:US
Mailing Address - Phone:317-827-6833
Mailing Address - Fax:317-344-3145
Practice Address - Street 1:11398 OLIO RD
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7605
Practice Address - Country:US
Practice Address - Phone:317-827-6833
Practice Address - Fax:317-344-3145
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:STRETCH ZONE FRANCHISING LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-02-28
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports MedicineGroup - Single Specialty