Individual
KASSIE OVERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
740 W 15TH ST, PUEBLO, CO 81003-2107
(719) 470-0753
Mailing address
826 W 22ND ST, PUEBLO, CO 81003-1825
(903) 787-1962
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0027743
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MT.0027743
OFFICE OF MASSAGE THERAPY LICENSURE
CO
Enumeration date
08/16/2025
Last updated
08/16/2025
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