Individual
MICHAEL ODISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2508 MOUNT MORIAH RD STE C554, MEMPHIS, TN 38115-1514
(901) 240-8359
Mailing address
2508 MOUNT MORIAH RD STE C554, MEMPHIS, TN 38115-1514
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/13/2017
Last updated
11/13/2017
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