Individual
MEGHAN P ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-6828
(678) 309-8159
(678) 309-8158
Mailing address
2041 MESA VALLEY WAY, SUITE 100, AUSTELL, GA 30106-6828
(678) 309-8159
(678) 309-8158
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT007810
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
730847132A
—
GA
Enumeration date
09/29/2006
Last updated
02/03/2011
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