Individual
MARY ANNE E ODANIEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
444 S MAIN ST, MADISONVILLE, KY 42431
(270) 825-0069
(270) 824-9777
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-1330
(270) 688-1338
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007430
KY
225100000X
Physical Therapist
TP2018037
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100552180
—
KY
Enumeration date
05/09/2018
Last updated
03/06/2019
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