Individual
LESLIE E ODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
781 FAR HILLS DR STE 100, NEW FREEDOM, PA 17349-8447
(717) 759-5929
(717) 563-0348
Mailing address
781 FAR HILLS DR STE 100, NEW FREEDOM, PA 17349-8447
(717) 759-5929
(717) 563-0348
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG001304
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1432309
BLUE SHIELD
PA
01
—
50034412
CAPITAL BLUE CROSS
PA
Enumeration date
08/02/2005
Last updated
04/06/2022
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