ADVANCED WELLNESS SPORTS AND SPINE, PC

DAVENPORT, IA
NPI1992095582
Entity TypeOrganization
Authorized ContactBRETT C. LOCKMAN
Owner
563-332-2152
Organization Subpart ?No
Primary Taxonomy208100000X Physical Medicine & Rehabilitation
(Licence: IA  4156)
Additional Taxonomies2081P2900X Physical Medicine & Rehabilitation, Pain Medicine
(Licence: IA  4156)
2081S0010X Physical Medicine & Rehabilitation, Sports Medicine
(Licence: IA  4156)
Enumeration Date2011-04-15
Last Update Date2012-10-22
Business Address
ADVANCED WELLNESS SPORTS AND SPINE, PC
4550 E 53RD ST SUITE 100
DAVENPORT, IA 52807-3171
Phone number: 563-332-2152
Mailing Address
ADVANCED WELLNESS SPORTS AND SPINE, PC
4550 E 53RD ST SUITE 100
DAVENPORT, IA 52807-3171
Phone number: 563-332-2152
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