Individual
COLIN JACOB OVERSTREET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1104 W MAIN ST, BENTON, IL 62812-1565
(618) 439-3399
(618) 439-4801
Mailing address
1104 W MAIN ST, BENTON, IL 62812-1565
(618) 439-3399
(618) 439-4801
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070.019280
IL
Other
Enumeration date
08/13/2012
Last updated
08/13/2012
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