Individual
POLYCARP ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4050 SMITHS LANDING CT, ABINGDON, MD 21009-1259
(443) 402-0722
Mailing address
4050 SMITHS LANDING CT, ABINGDON, MD 21009-1259
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
R4455
MD
Other
Enumeration date
09/03/2019
Last updated
09/03/2019
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