| NPI | 1972829372 |
|---|---|
| Other Name | EDI LLC. |
| Entity Type | Organization |
| Authorized Contact | KEVIN LAMONT JOHNSON CEO/Owner 317-504-1665 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: IN 261QP3300X) |
| Additional Taxonomies | 261QM1200X Clinic/Center, Magnetic Resonance Imaging (MRI) (Licence: IN 261QM1200X) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: IN 261QM1300X) | |
| 261QP1100X Clinic/Center, Podiatric (Licence: IN 261QP1100X) | |
| 261QR0200X Clinic/Center, Radiology (Licence: IN 261QR0200X) | |
| Enumeration Date | 2010-04-12 |
| Last Update Date | 2010-04-12 |