Organization
ADVANCED DIAGNOSTIC IMAGING, PC
Active
Other names
Mendoza Podiatry
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN FENTON (CREDENTIALING MANAGER)
(615) 851-6033
Entity
Organization
Contact information
Practice address
353 NEW SHACKLE ISLAND RD STE 120B, HENDERSONVILLE, TN 37075-2329
(615) 826-0941
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 851-6033
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
—
—
Other
Enumeration date
06/04/2020
Last updated
06/04/2020
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