Individual
MR. MICHAEL ALLEN ODOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
5900 N LOTZ RD, CANTON, MI 48187-4331
(734) 394-4547
(734) 394-4650
Mailing address
5900 N LOTZ RD, CANTON, MI 48187-4331
(313) 673-7494
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
4703095116
MI
Other
Enumeration date
12/15/2022
Last updated
12/15/2022
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