Restoration Spine & Sport Chiropractic

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

RESTORATION SPINE & SPORT CHIROPRACTIC

Practice address

110 Evans Mill Dr Ste 309
Dallas, GA 30157-1623

Phone

(678) 594-3579

NPI assigned

Mar 27, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Martin R Wilson, DC

Title

Ceo

Phone

(678) 594-3579

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1553644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553644800000",
    "number": "1902367535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 EVANS MILL DR STE 309",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301571623",
            "telephone_number": "678-594-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 EVANS MILL DR STE 309",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301571623",
            "telephone_number": "678-594-3579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION SPINE & SPORT CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-27",
        "last_updated": "2019-03-27",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-594-3579",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Renard
• Evita Hanayo Renfroe, LPN
• Naomi Chineye Renfroe, HT(ASCP) CM, CPT
• Renu Health LLC
• Resilient Roots Parenting & Life Coaching, LLC
• Kawanza Roach
• Robert T Cecil Enterprises Inc
• Alivia Roberts
• Daiyaan Roberts
• Atli Robinson

• Chiropractor in Dallas, GA
• Providers in Dallas, GA by specialty
• Chiropractor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2019; 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.