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General NPI Number Information
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NPI Number | 1982240917
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Entity Type | Organization
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Legal Business Name | ADVANCED PAIN MANAGEMENT OF ELWOOD
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Dates
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Enumeration Date | 11/25/2019
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 7408 W STATE ROAD 28
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City | ELWOOD
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State | IN
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Zip | 46036-8600
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Country | US
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Telephone | 765-557-8569
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Fax | 765-557-8635
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Provider Business Mailing Address
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Address Line | 7408 W STATE ROAD 28
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City | ELWOOD
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State | IN
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Zip | 46036-8600
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Country | US
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Telephone | 765-557-8569
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Fax | 765-557-8635
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Authorized Official
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Title or Position | OWNER
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Name | DAVID DUNHAM
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Credential | NP, DPT, DC
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Telephone | 765-557-8569
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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