Most Relevant Information
Provider Data
| NPI Number: | 1003044124 |
| Provider Name: | MARK OVERTON |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/26/2009 |
| Last Updated: | 06/26/2009 |
Provider Practice Location
3881 S WESTERN AVE
LOS ANGELES
CA
900621105
Practice Location Phone/Fax
| Phone: | 3232904374 |
| Fax: |
Provider Mailing Location
1201 E 7TH ST RM APT216
LOS ANGELES
CA
900211505
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |