Individual
MS. CLO ELLEN OVERCAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RMT
Contact information
Practice address
1819 W COLORADO AVE, COLORADO SPRINGS, CO 80904-3836
(719) 635-3555
Mailing address
PO BOX 574, FOUNTAIN, CO 80817-0574
(719) 237-7958
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT1169
CO
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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