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Individual
DR. JERRY DEANIE ODOM SR.
Active
Individual
DR. JERRY DEANIE ODOM SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038-010666
IL
111N00000X
Chiropractor
Primary
3522
SC
Other
Enumeration date
04/16/2007
Last updated
08/26/2010
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