Individual
BRYAN SHO ODAKURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1025 E WEST CONNECTOR, STE 406, AUSTELL, GA 30106-8513
(770) 384-1001
(770) 384-0333
Mailing address
8823 PRODUCTION LN, OOLTEWAH, TN 37363-6511
(423) 238-8907
(423) 954-7408
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
GA
Other
Enumeration date
08/20/2014
Last updated
08/20/2014
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