OrganizationActive
Advanced Wellness Sports and Spine, PC
NPI 1992095582 · Physical Medicine & Rehabilitation Physician · Davenport, IA
Provider details
- NPI number
- 1992095582
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Authorized official
- Brett Lockman, Owner
- License
- 4156 (IA)
Practice location
4550 E 53rd St
Suite 100
Davenport, IA 52807-3171
Phone: (563) 332-2152
Fax: (563) 332-2153
Mailing address
4550 E 53rd St
Davenport, IA 52807-3171
Registry dates
- Enumerated
- 2011-04-15
- Last updated
- 2012-10-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.