Individual
KELSEY MARIE ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
731 POLO RD, COLUMBIA, SC 29223-4462
(803) 788-8655
Mailing address
1106 THREE CHOP RUN, LEXINGTON, SC 29072-9216
(803) 960-9855
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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