Pro-Active Wellness Center, Nathan Clark Chiropractic, Professional Corporation

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

PRO-ACTIVE WELLNESS CENTER, NATHAN CLARK CHIROPRACTIC, PROFESSIONAL CORPORATION

Practice address

2310 Artesia Blvd
Redondo Beach, CA 90278-3114

Phone

(310) 372-2063

NPI assigned

Apr 14, 2025

Last updated

Apr 14, 2025By the provider in NPPES

Organization subpart

Yes

Parent organization

PRO-ACTIVE WELLNESS CENTER, NATHAN CLARK CHIROPRACTIC, PROFESSIONAL CORPORATIONAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Nathna Clark, D.C.

Title

President

Phone

(847) 477-7845

Specialties & licenses 1

Addresses

Other names 1

• Pro-active Wellness Center Other name

Part of

Pro-Active Wellness Center Nathan Clark Chiropractic Professional Corporation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1744588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744588800000",
    "number": "1558156182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783114",
            "telephone_number": "310-372-2063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 ARTESIA BLVD",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902783114",
            "telephone_number": "310-372-2063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-ACTIVE WELLNESS CENTER, NATHAN CLARK CHIROPRACTIC, PROFESSIONAL CORPORATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRO-ACTIVE WELLNESS CENTER, NATHAN CLARK CHIROPRACTIC, PROFESSIONAL CORPORATION",
        "enumeration_date": "2025-04-14",
        "last_updated": "2025-04-14",
        "certification_date": "2025-04-14",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "NATHNA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-477-7845",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro-active Wellness Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Dianne Preciado, MA., AMFT
• Premiere Chiropractic and Sports Medicine
• Premiere Physical Therapy and Rehabilitation
• Kristin Price, LAC
• Melissa Prince
• Pro-Health Physical Therapy Inc.
• Pro-Life Imaging LLC
• Pro-Life Imaging LLC
• Patricia Lynn Procetto, APCC19721
• Marykatherine Proietta

• Sports Physician Chiropractor in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• Sports Physician Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.