Individual
JILL L OVERLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
33 PENN PLZ # B, BANGOR, ME 04401-3619
(207) 990-2050
Mailing address
2177 WESTERN AVE, NEWBURGH, ME 04444-4548
(207) 234-4027
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
432349399
—
ME
Enumeration date
10/24/2006
Last updated
11/04/2016
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