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NPI Code Detail

MEDICARE: DR. JEREMY DAVID OVERHOLT D.C.

MEDICARE:  DR. JEREMY DAVID OVERHOLT  D.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111N00000XChiropractor6019CO

General Provider Information

NPI Number : 1740329911
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEREMY DAVID OVERHOLT D.C.
Provider Business Mailing Address
First Line : 1930 UNITY CT
Second Line :
City : FORT COLLINS
State : CO
Zip : 80528-6362
Country : US
Telephone Number : 970-689-3066
Fax Number :
Provider Business Practice Location Address
First Line : 1103 OAK PARK DR
Second Line :
City : FORT COLLINS
State : CO
Zip : 80525-6273
Country : US
Telephone Number : 970-226-1400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2007
Last Update Date : 03/04/2009

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Directions to “ DR. JEREMY DAVID OVERHOLT D.C.” Practice Location

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