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DR. LORA OVERTON PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LORA OVERTON DO (OWNER/PHYSICIAN)
(260) 490-1524
Entity
Organization

Contact information

Practice address
3217 LAKE AVE, FORT WAYNE, IN 46805-5427
(260) 490-1524
Mailing address
PO BOX 112, MUNCIE, IN 47308-0112
(765) 284-0493
(765) 284-2434

Taxonomy

Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
02001611
IN

Other

Enumeration date
11/27/2012
Last updated
11/27/2012
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