Individual
MR. BRENTFORD ALLEN OVERTON
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.S.P.T.
Contact information
Practice address
1881 N BAT MASTERSON LN, PUEBLO WEST, CO 81007-1255
(719) 320-6387
Mailing address
1881 N BAT MASTERSON LN, PUEBLO WEST, CO 81007-1255
(719) 320-6387
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7212
CO
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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