Organization
COM-RAD MOBILE IMAGING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK MINTON (PRESIDENT)
(423) 650-8353
Entity
Organization
Contact information
Practice address
339 BENWOOD TRL NE, CLEVELAND, TN 37323-5096
(423) 650-8353
(336) 245-0649
Mailing address
339 BENWOOD TRL NE, CLEVELAND, TN 37323-5096
(423) 650-8353
(336) 245-0649
Taxonomy
Speciality
Code
Description
License number
State
335V00000X
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3400012
—
TN
Enumeration date
03/01/2007
Last updated
07/19/2011
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