Individual
TRAVIS ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MAT, LAT, ATC
Contact information
Practice address
103 S LHS DR, LUMBERTON, TX 77657-8601
(904) 316-1873
Mailing address
187 SOUTH L.H.S. DRIVE, APT 103, LUMBERTON, TX 77657
(904) 316-1873
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT7117
TX
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/30/2017
Last updated
07/21/2022
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