NPI 1992095582

Advanced Wellness Sports and Spine, PC

Organisation Physical Medicine & Rehabilitation Physician Davenport, IA

Practice location

Address: 4550 E 53rd St Suite 100, Davenport, IA 52807-3171
Phone: (563) 332-2152
Fax: (563) 332-2153

Authorised official

Name: Brett C. Lockman
Title: Owner
Phone: (563) 332-2152

Registered specialties (3)

Physical Medicine & Rehabilitation Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208100000X Licence 4156 (IA)

Other Physical Medicine & Rehabilitation providers in Iowa →

Pain Medicine (Physical Medicine & Rehabilitation) Physician

Allopathic & Osteopathic Physicians Taxonomy 2081P2900X Licence 4156 (IA)

Sports Medicine (Physical Medicine & Rehabilitation) Physician

Allopathic & Osteopathic Physicians Taxonomy 2081S0010X Licence 4156 (IA)

Registry record

NPI: 1992095582
Entity type: Organization
NPI issued: 15 Apr 2011
Record last updated: 22 Oct 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.