Individual
MR. BRUCE M O'DELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LOTR
Contact information
Practice address
3446 MASONIC DR, ALEXANDRIA, LA 71301-3615
(318) 880-0058
(318) 880-0059
Mailing address
3446 MASONIC DR, ALEXANDRIA, LA 71301-3615
(318) 880-0058
(318) 880-0059
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
Z11902
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00474235
RAILROAD MEDICARE
LA
01
—
Z11902
OCCUPATIONAL THERAPY LIC#
LA
Enumeration date
05/16/2006
Last updated
12/20/2012
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