Organization
ADVANCED DIAGNOSTIC IMAGING, PC
Active
Other names
Premier Foot & Ankle Centers of Tennessee
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN FENTON (CREDENTIALING MANAGER)
(615) 854-3409
Entity
Organization
Contact information
Practice address
1428 SPARTA ST STE 4, MCMINNVILLE, TN 37110-1365
(931) 507-3668
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 239-2018
(615) 851-2018
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
09/04/2021
Last updated
09/04/2021
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