Elevated Diagnostic Imaging and Pain Management Center LLC

NPI #1972829372 in Greenwood, Indiana

Provider Information

NPI Number: 1972829372
Entity Type: Organization
Organization Name: Elevated Diagnostic Imaging and Pain Management Center LLC
Primary Specialty: Clinic/Center - Pain
Enumeration Date: Apr 12, 2010
Last Updated: Apr 12, 2010

Practice Location

Address: 1642 OLIVE BRANCH PARK LN
City: Greenwood
State: Indiana
ZIP Code: 46143-6447
Phone: (317) 504-1665

Authorized Official

Name: MR. KEVIN LAMONT JOHNSON, RT
Title: CEO/OWNER
Phone: (317) 504-1665

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Magnetic Resonance Imaging (MRI) — Magnetic Resonance Imaging (MRI)	261QM1200X
Clinic/Center - Multi-Specialty — Multi-Specialty	261QM1300X
Clinic/Center - Podiatric — Podiatric	261QP1100X
Clinic/Center - Radiology — Radiology	261QR0200X
Clinic/Center - Pain — Pain	261QP3300X	Primary

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