Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Multi-Specialty |
261QM1300X | 70 | Clinic or Group Practice | |
Clinical Medical Laboratory |
291U00000X | 69 | Clinical Laboratory | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company | |
Interventional Pain Medicine |
208VP0014X | 09 | Physician/Interventional Pain Management | |
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner | |
Physical Therapist |
225100000X | 65 | Physical Therapist in Private Practice |
| NPI # | 1982240917 |
| LBN Legal business name | ADVANCED PAIN MANAGEMENT OF ELWOOD |
| Authorized official | DAVID DUNHAM - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 11/25/2019 |
| Last updated | 07/12/2022 - About 4 years ago |
| Identifiers | n/a |
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