PROSPORT WELLNESS CENTER, LLC (NPI# 1689798811) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689798811 |
| Entity Type | Organization |
| Organization Name | PROSPORT WELLNESS CENTER, LLC |
| Practice Address |
2000 Powers Ferry Rd. Suite A Marietta GA 30067 |
| Mailing Address |
5464 Peachtree Industrial Blvd Chamblee GA 30341 |
| Practice Telephone | 7704548300 |
| Practice Fax Number | 7709869962 |
| Mailing Telephone | 7704548300 |
| Mailing Fax Number | 7709869962 |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL B WAX (CEO) |
| Authorized Official Telephone | 7704548300 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111NR0400X |
Chiropractor Specialization: Rehabilitation |
CHIR005750 | GA | Chiropractic Providers |
| Street Address |
2000 POWERS FERRY RD. SUITE A |
| City | MARIETTA |
| State | GA |
| Zip Code | 30067 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689140022 | Sherry Wilson King | Marriage & Family Therapist | 1640 Powers Ferry Rd Blg 7, Ste 300, Marietta, GA 30067 | 2018-10-23 |
| 1053886861 | Precious Angel Home Care Services Inc | Adult Companion | 2470 Windy Hill Road, Marietta, Suite 253, Marietta, GA 30067 | 2018-10-08 |
| 1194206466 | Joshua P Moree | Chiropractor | 860 Franklin Gtwy Se Apt 111, Marietta, GA 30067 | 2018-08-24 |
| 1841778081 | Sun Pediatrics LLC | Pediatrics | 2520 Windy Hill Rd Se Ste 104, Marietta, GA 30067 | 2018-07-31 |
| 1508358714 | Mbs Wellness Group, LLC | Durable Medical Equipment & Medical Supplies | 62 Shawnee Trail Se, Marietta, GA 30067 | 2018-06-04 |
| 1497254213 | Allison M Jancik | Chiropractor | 1355 Terrell Mill Road Se, Bldg 1474, Ste 150, Marietta, GA 30067 | 2018-02-07 |
| 1801304969 | Danielle Ann Dietrich | Chiropractor | 805 Winterset Pkwy Se, Marietta, GA 30067 | 2018-01-11 |
| 1740794866 | Jessica Lofgren | Chiropractor | 1130 Northchase Pkwy Se Ste 125, Marietta, GA 30067 | 2017-11-28 |
| 1871026393 | Rhonda Dawes Milner | Counselor | 1640 Powers Ferry Rd Bldg 16, Suite 100, Marietta, GA 30067 | 2017-04-11 |
| 1457894537 | Carcelia Delk | Counselor | 1110 Augusta Dr Se, Marietta, GA 30067 | 2016-11-22 |
| Find all providers in zip 30067 | ||||
| Taxonomy Code | 111NR0400X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Rehabilitation |
| Rehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are defined as those activities in one's daily life, work, or sports and recreational activities that an individual participates in. Relevant impairments (e.g. strength, endurance, flexibility, motor control, etc.) are often intermediate goals of rehabilitation, but the final goal of successful care is return to participation in activities in which the patient was successful before the onset of the injury or disease. Essential to a rehabilitation approach is a focus on patient-centered outcomes such as independence and self-management or self-care skills. |
| Notes: Source: The American Chiropractic Association (ACA) and the ACA Council on Physiological Therapeutics [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093088759 | John Michael Ertle | Chiropractor | 1033 Franklin Rd Se Ste C, Marietta, GA 30067-8005 | 2012-02-10 |
| 1306159900 | Back To Genesis Chiropractic, PC | Chiropractor | 3812 Austell Rd Sw, Marietta, GA 30008-5863 | 2010-07-23 |
| 1922202001 | Integrated Health Services | Chiropractor | 3405 Dallas Hwy Sw Ste 301, Marietta, GA 30064-6426 | 2007-06-13 |
| 1023224763 | Gwendolyn M Tutt | Chiropractor | 1714 Paddlewheel Dr, Marietta, GA 30062-3853 | 2007-05-16 |
| 1396875449 | Thaddeus James Layton | Chiropractor | 1226 Franklin Rd Se, Marietta, GA 30067-8702 | 2007-03-07 |
| 1689701153 | Advanta Medical & Physical Therapy | Chiropractor | 1720 Powers Ferry Rd Se, Ste 100, Marietta, GA 30067-5450 | 2007-02-28 |
| 1407983885 | Mitchell Shea Arnold | Chiropractor | 3894 Due West Rd Nw Ste 210, Marietta, GA 30064-1072 | 2007-02-27 |
| 1881770188 | Joseph Vance Haezebrouck | Chiropractor | 3660 Canton Rd, Suite 140, Marietta, GA 30066-2660 | 2006-10-29 |
| 1821174574 | Meirav Ertle | Chiropractor | 1033 Franklin Rd Se, Suite C, Marietta, GA 30067-8060 | 2006-10-27 |
| 1851918858 | Brian Herron | Chiropractor | 4343 Shallowford Rd Ste H6, Marietta, GA 30062-5023 | 2020-06-25 |
| Find all providers in MARIETTA | ||||
Please comment or provide details below to improve the information on PROSPORT WELLNESS CENTER, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.