Individual
BRYANT THOMAS OVERSTREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4016 W 95TH ST, PRAIRIE VILLAGE, KS 66207-2702
(913) 307-3057
Mailing address
610 NE 66TH TER, GLADSTONE, MO 64118-3440
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
3-111378
KS
Other
Enumeration date
09/14/2020
Last updated
09/14/2020
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