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General NPI Number Information
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NPI Number | 1770207409
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Entity Type | Individual
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Provider Name | AARON OVERHISER DPT
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Gender | Male
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Dates
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Enumeration Date | 09/27/2022
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 11595 E LAKEWOOD BLVD STE 80
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City | HOLLAND
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State | MI
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Zip | 49424-8695
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Country | US
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Telephone | 616-594-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 6317 107TH AVE
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City | SOUTH HAVEN
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State | MI
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Zip | 49090-9381
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Country | US
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Telephone | 269-363-3236
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501302280
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License Number State | MI
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