Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Advanced Wellness Sports and Spine, PC

Organization Physical Medicine & Rehabilitation Physician · NPI 1992095582

Advanced Wellness Sports and Spine, PC is a Physical Medicine & Rehabilitation Physician in Davenport, Iowa. Licensed in Iowa. Registered with an NPI since 2011.

Licensed in
IA
In the registry since
2011
Specialties on file
3
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4550 E 53rd St Ste 100
Davenport, IA 52807-3171
Phone: (563) 332-2152
Fax: (563) 332-2153
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Medicine & Rehabilitation Physician (primary) Taxonomy 208100000X · Licence 4156 (IA)
Pain Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081P2900X · Licence 4156 (IA)
Sports Medicine (Physical Medicine & Rehabilitation) Physician Taxonomy 2081S0010X · Licence 4156 (IA)

Record details

NPI number1992095582
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brett Lockman — Owner · (563) 332-2152
NPI enumeratedApril 15, 2011
Last updated in NPPESOctober 22, 2012
Mailing address4550 E 53rd St, Suite 100, Davenport, IA 52807-3171

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