Individual
FRED ODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5917 HIGH ST W, PORTSMOUTH, VA 23703-4505
(757) 686-5929
Mailing address
5917 HIGH ST W, PORTSMOUTH, VA 23703-4505
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0202005268
VA
Other
Enumeration date
09/12/2011
Last updated
03/15/2012
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