Provider Demographics
NPI:1518946698
Name:OVERSTREET, JEFFREY C (DC)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:OVERSTREET
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 TOWNSHIP ROAD 1154
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-8907
Mailing Address - Country:US
Mailing Address - Phone:740-894-0001
Mailing Address - Fax:
Practice Address - Street 1:6467 FARMDALE RD
Practice Address - Street 2:
Practice Address - City:BARBOURSVILLE
Practice Address - State:WV
Practice Address - Zip Code:25504-1305
Practice Address - Country:US
Practice Address - Phone:304-736-2050
Practice Address - Fax:304-736-3570
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-17
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVT32453Medicare UPIN