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Individual

LESLIE ODOM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
711 E MAIN ST, LIBERTY, MS 39645-7052
(601) 730-4151
Mailing address
711 E MAIN ST, LIBERTY, MS 39645-7052

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
3749
MS

Other

Enumeration date
06/02/2011
Last updated
06/03/2026
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