Organization
DIVERIS ORTHOPEDICS AND SPORTS MEDICINE,PC
Active
Other names
KDM Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN M DIVERIS MD (PRESIDENT)
(219) 263-8849
Entity
Organization
Contact information
Practice address
2562 WALTON BLVD, WARSAW, IN 46582-6522
(219) 263-8849
(219) 476-0108
Mailing address
2562 WALTON BLVD, WARSAW, IN 46582-6522
(219) 263-8849
(574) 267-2866
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
01040065A
IN
Other
Enumeration date
05/08/2007
Last updated
06/09/2023
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