Healthcare Provider Details

I. General information

NPI: 1629582622
Provider Name (Legal Business Name): CYNTHIA MARIE OVERTURF RDN, CDE, BC-ADM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2017
Last Update Date: 11/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2475 E BROADWAY ST
HELENA MT
59601-4928
US

IV. Provider business mailing address

2475 E BROADWAY ST
HELENA MT
59601-4928
US

V. Phone/Fax

Practice location:
  • Phone: 406-444-2133
  • Fax: 406-447-2703
Mailing address:
  • Phone: 406-444-2133
  • Fax: 406-447-2703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number722522
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: