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ANGELA ODOM

>> Massage Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1750831707

Individual Registrant:
 ANGELA  ODOM 
Gender: F
Sole Proprietor

Location and contact information for practice:
195 FIOLI CIR  GRANITEVILLE, SC 29829-3991 US
Tel: 803-640-7708  Fax: --

Contact information for business:
195 FIOLI CIR  GRANITEVILLE, SC 29829-3991 US
Tel: 803-640-7708  Fax: --

Registration Information:
NPI: 1750831707
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
SC5656
N225700000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Massage Therapist
GAMT005041

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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