Provider Demographics
NPI:1649478033
Name:OVERLAND, JAMES T JR (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:T
Last Name:OVERLAND
Suffix:JR
Gender:M
Credentials:DC
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Mailing Address - Street 1:55 S VALLE VERDE
Mailing Address - Street 2:STE 450
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89012-3110
Mailing Address - Country:US
Mailing Address - Phone:702-614-9500
Mailing Address - Fax:702-614-9505
Practice Address - Street 1:55 S VALLE VERDE
Practice Address - Street 2:SUITE 450
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89012-3110
Practice Address - Country:US
Practice Address - Phone:702-614-9500
Practice Address - Fax:702-614-9505
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NVNV B-526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
30912Medicare UPIN