Individual
JESSALYN RIEDEL ODEGAARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
824 GUM BRANCH RD STE W, JACKSONVILLE, NC 28540-6269
(252) 672-8680
Mailing address
3441 STONE ST, CAMP LEJEUNE, NC 28547-1428
(703) 727-5534
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P19650
NC
Other
Enumeration date
10/19/2020
Last updated
10/19/2020
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