Individual
MATTIE JANE OVERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
24422 AVENIDA DE LA CARLOTA STE 190, LAGUNA HILLS, CA 92653-3634
(949) 340-6927
Mailing address
24422 AVENIDA DE LA CARLOTA STE 190, LAGUNA HILLS, CA 92653-3634
(949) 340-6927
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
PT295297
CA
2081N0008X
Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician
Primary
PT295297
CA
Other
Enumeration date
09/11/2018
Last updated
10/26/2018
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