Organization
SPORTS PERFORMANCE CONCEPTS, LLC
Active
Organization
SPORTS PERFORMANCE CONCEPTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN ASHLEY CORTJENS DC, CCSP, QME, IIE (OWNER)
(470) 239-0770
Entity
Organization
Contact information
Practice address
3985 LAKEFIELD CT STE 206, SUWANEE, GA 30024-1209
(470) 239-0770
Mailing address
3985 LAKEFIELD CT STE 206, SUWANEE, GA 30024-1209
(470) 239-0770
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
CHIR009018
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1063760635
TYPE I NPI
GA
01
—
1467144220
TYPE 1 NPI FOR IR
GA
01
—
1518380938
TYPE 2 NPI
GA
Enumeration date
02/05/2014
Last updated
08/31/2023
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