Individual
KAILIE MIDORI ODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3024 W 300 N STE B, WEST POINT, UT 84015-7259
(801) 825-7500
Mailing address
1395 TROON DR, SYRACUSE, UT 84075-9749
(801) 589-5880
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/19/2023
Last updated
01/19/2023
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