Individual
JEFFREY SHAWN ODOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5000 E SHENNUM DR, WASILLA, AK 99654-7718
(907) 352-1200
(907) 352-1249
Mailing address
801 N REED CT, WASILLA, AK 99654-6750
(907) 352-1200
(907) 352-1249
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/20/2008
Last updated
08/20/2008
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