Individual
JOSHUA ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
901 W INTERSTATE 30, ROYSE CITY, TX 75189-7518
(972) 636-9100
Mailing address
6166 GAMGEE ST, FORT WORTH, TX 76179-1882
(817) 988-5045
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
215044
TX
Other
Enumeration date
11/05/2019
Last updated
11/05/2019
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