Individual
MRS. DIANA LYNN MONTGOMERY
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
60 LONG AVE, PARSONS, TN 38363-2429
(731) 847-3676
(731) 847-6290
Mailing address
60 LONG AVE, PARSONS, TN 38363-2429
(731) 847-3676
(731) 847-6290
Taxonomy
Speciality
Code
Description
License number
State
225000000X
Orthotic Fitter
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31635
TLC
TN
01
—
4021848
BCBS
TN
Enumeration date
07/18/2005
Last updated
07/08/2007
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