# HIGHLANDS PAIN MANAGEMENT

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1851830640
- **Authorized official:** DR. CLYDE JOHNSON DC MS-REHAB MS-NUTRI (OWNER)
- **Authorized official phone:** (760) 449-7641

## Contact information

- **Practice address:** 5950 S WILLOW DR STE 200, GREENWOOD VILLAGE, CO 80111-5144
- **Practice address phone:** (720) 515-8002
- **Practice address fax:** (303) 741-2676
- **Mailing address:** 5950 S WILLOW DR, GREENWOOD VILLAGE, CO 80111-5170
- **Mailing address phone:** (720) 515-8002
- **Mailing address fax:** (303) 741-2676

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM2500X | Medical Specialty Clinic/Center | CHR.0006922 | CO | Yes |
| 261QP2000X | Physical Therapy Clinic/Center | CHR.0006922 | CO | — |
| 261QP3300X | Pain Clinic/Center | CHR.0006922 | CO | — |
| 261QR0400X | Rehabilitation Clinic/Center | CHR.0006922 | CO | — |
| 261QU0200X | Urgent Care Clinic/Center | CHR.0006922 | CO | — |

## Other

- **Enumeration date:** 02/14/2017
- **Last updated:** 02/14/2017