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General NPI Number Information
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NPI Number | 1447134978
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Entity Type | Organization
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Legal Business Name | FORTIS SPORTS PERFORMANCE, LLC
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Dates
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Enumeration Date | 08/05/2025
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Last Update Date | 08/10/2025
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Provider Practice Location Address
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Address Line | 3046 PEACHTREE DR NE
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City | ATLANTA
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State | GA
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Zip | 30305-7900
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Country | US
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Telephone | 404-309-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 3046 PEACHTREE DR NE
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City | ATLANTA
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State | GA
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Zip | 30305-7900
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Country | US
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Telephone | 404-309-8888
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANDREW WOLVERTON
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Credential | DPT
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Telephone | 404-309-8888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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