Individual
CASANDRA ODOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
222 N 2ND ST STE 204, BOISE, ID 83702-6130
(208) 429-9100
Mailing address
222 N 2ND ST STE 204, BOISE, ID 83702-6130
(208) 429-9100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5271988
ID
Other
Enumeration date
07/20/2023
Last updated
01/05/2026
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