Organization
ANDERSONTIERNAN, INC
Active
Parent organization
ANDERSONTIERNAN, INC
Other names
Advanced Foot & Ankle Centers of Illinois
Organization subpart
Yes
Provider details
NPI number
Legal business name
ANDERSONTIERNAN, INC
Authorized official
DR. BRECK M. TIERNAN DPM (MEDICAL DIRECTOR)
(815) 553-0990
Entity
Organization
Contact information
Practice address
350 HOUBOLT RD, SUITE 104, JOLIET, IL 60431-8305
(815) 553-0990
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
10/25/2012
Last updated
10/25/2012
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