MEDICARE: STRETCHMED TUCSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1396510434
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	STRETCHMED TUCSON

Provider Business Mailing Address
First Line	:	64 E BROADWAY BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85701-1720
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	64 E BROADWAY BLVD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85701-1720
Country	:	US
Telephone Number	:	520-444-6973
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JENNICA KLEMANN
Credential	:
Telephone Number	:	520-850-8151

Provider Enumeration Date	:	11/20/2023
Last Update Date	:	11/20/2023

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Directions to “STRETCHMED TUCSON ” Practice Location

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