ADVANCED WELLNESS & SPORTS REHAB PA


Address: 11132 Commerce Ln N, Champlin, MN 55316-3112
Phone: 7632910202

ADVANCED WELLNESS & SPORTS REHAB PA (NPI# 1790181915) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1790181915
Entity Type Organization
Organization Name ADVANCED WELLNESS & SPORTS REHAB PA
Practice Address 11132 Commerce Ln N
Champlin
MN 55316-3112
Practice Telephone 7632910202
Mailing Telephone 7632910202
Enumeration Date 2014-11-16
Last Update Date 2018-03-17
Authorized Official Name DR. DIANE K SMITH (PRESIDENT)
Authorized Official Telephone 7634586299
Authorized Official Credential DC
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 111NS0005X Chiropractor
Specialization: Sports Physician
5614 MN Chiropractic Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
232 Central Ave, Osseo, MN 553691245 7634586299

Office Location

Street Address 11132 COMMERCE LN N
City CHAMPLIN
State MN
Zip Code 55316-3112

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1801493903 Shoptikal LLC Eyewear Supplier (Equipment, not the service) 11995 Business Park Blvd N, Champlin, MN 55316 2020-10-02
1598300675 Dentalign, Pa Dentist 11942 Business Park Blvd, Champlin, MN 55316 2019-11-12
1811463573 Vikings Home Health Care LLC Meals 11551 Georgia Ave, N, Champlin, MN 55316 2018-10-22
1255853305 Matthew L Boelter Hearing Instrument Specialist 11451 Oregon Ave N, Champlin, MN 55316 2017-07-11
1194198309 Champlin Dentistry, PC Dentist 11231 Aquila Drive N, Champlin, MN 55316 2015-11-10
1336557412 Kelsey Voigt Pharmacist 11990 Business Park Blvd, Champlin, MN 55316 2014-08-01
1346502523 Transitions Home Care Ltd Home Health 11030 Douglas Drive North, Champlin, MN 55316 2012-06-13
1639373285 Michael D Smilanich Dentist 11231 Aquila Dr N, Champlin, MN 55316 2007-06-14
1760532907 Kurt Allan Bender Dentist 500 A Jefferson Hwy, Champlin, MN 55316 2007-01-11
1366529752 Gregory Allan Holmberg Chiropractor #8 3rd Street Nw, Osseo, MN 55316 2006-11-01
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Taxonomy Information

Taxonomy Code 111NS0005X
Grouping Chiropractic Providers
Classification Chiropractor
Specialization Sports Physician

Taxonomy Definition

A sports chiropractor is uniquely trained to provide care and treatment of injuries or illness resulting from sports and physical fitness activities. Doctors of Chiropractic with the Diplomate American Chiropractic Board of Sports Physicians (DACBSP) or the Certified Chiropractic Sports Physician (CCSP), sport specialty certifications from the American Chiropractic Board of Sports Physicians, have advanced training in the assessment, management and rehabilitation of sports related injuries. Extremity care, rehabilitation and soft tissue procedures are common skills utilized by these doctors. The specialty training covers a broad spectrum from the pediatric athlete to professional and Olympic athletes, and everything in between, using a variety of techniques and modalities.
Notes: Source: American Chiropractic Board of Sports Physicians, 2009 [7/1/2009: definition added]

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1902293202 Twin Cities Spine & Sports, LLC Chiropractor 4510 W 77th St, Suite 222, Edina, MN 55435-5505 2015-04-24
1831587930 Ibackcheck Chiropractic Chiropractor 3650 Plymouth Blvd, Suite 100, Plymouth, MN 55446-3201 2014-12-26
1063857621 Minnesota Spine & Sports Rehab Chiropractor 29 S Walnut St Ste 200, La Crescent, MN 55947-1605 2013-05-08
1508128232 New Creation Sports and Wellness, LLC Chiropractor 7500 Hudson Blvd N Ste 180, Oakdale, MN 55128-7064 2012-06-08
1659659159 Bradley Owen Olson Chiropractor 1312 Delaware St Nw, Hutchinson, MN 55350-3301 2011-08-01
1265738421 Don Lee Jewell Chiropractor 11222 86th Ave N, Maple Grove, MN 55369-4510 2011-02-07
1790089654 Kaitlin Renee Battaglia Chiropractor 5250 W 74th St Ste 8, Edina, MN 55439-2229 2011-01-06
1881902591 Dr. Kim Leis-keeling, LLC Chiropractor 2121 Cliff Dr Ste 101, Eagan, MN 55122-3407 2010-09-15
1740430651 Sarah Mae Peters Chiropractor 6982 Alpine Trl, Eden Prairie, MN 55346-3739 2008-09-27
1538334776 Brian D Gervais Chiropractor 6104 Olson Memorial Hwy, Suite 100, Golden Valley, MN 55422-4919 2008-04-29
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Competitor

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City CHAMPLIN
Zip Code 55316

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Dataset Information

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.

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