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General NPI Number Information
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NPI Number | 1508694241
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Entity Type | Organization
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Legal Business Name | STRETCHY.US LLC
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Dates
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Enumeration Date | 07/24/2024
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Last Update Date | 08/28/2024
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Provider Practice Location Address
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Address Line | 2401 EAST 3RD AVE
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City | SAN MATEO
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State | CA
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Zip | 94404
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Country | US
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Telephone | 916-812-4190
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Fax |
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Provider Business Mailing Address
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Address Line | 600 MARINERS ISLAND BLVD APT 6
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City | SAN MATEO
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State | CA
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Zip | 94404-1022
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Country | US
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Telephone | 916-812-4190
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | BRANDON BAKHTIAR
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Credential |
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Telephone | 916-812-4190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172M00000X
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Taxonomy Name | Mechanotherapist
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License Number |
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License Number State |
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