Individual
ODELL SAMUEL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6439 GARNERS FERRY RD, PSYCHIATRIC BUILDING 106, COLUMBIA, SC 29209-1638
(803) 776-4000
(803) 695-6795
Mailing address
6439 GARNERS FERRY RD, PSYCHIATRIC BUILDING 106, COLUMBIA, SC 29209-1638
(803) 776-4000
(803) 695-6795
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
166564E
SC
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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