Organization
DIVERSE MEDICAL MANAGEMENT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NATALIE FREY (AUTHORIZED REP/OFFICE MANAGER)
(931) 815-8525
Entity
Organization
Contact information
Practice address
82 BECKRIDGE RD, MCMINNVILLE, TN 37110-5006
(931) 409-4350
Mailing address
82 BECKRIDGE RD, MCMINNVILLE, TN 37110-5006
(931) 409-4350
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4633
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207575
—
AL
05
—
Q007193
—
TN
Enumeration date
08/12/2014
Last updated
10/17/2018
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