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Laura Elizabeth Odom
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NPI Number Detailed Information
Provider Information:
| Name: | Laura Elizabeth Odom |
| Gender: | F |
| Provider License Number If Given: | RN142096 |
NPI Information:
| NPI: | 1295720720 |
| Entity Type (Individual or Organization): |
1-ind |
| Enumeration Date: | 9/12/2005 |
| Last Update Date: | 4/9/2014 |
Provider Business Mailing Address:
| Address: | 6701 BAUM DR SUITE 140 Knoxville, TN 37919 |
| Phone Number: | 8655845727 |
| Fax Number: | 8654509904 |
Provider Business Practice Location Address:
| Address: | 801 N WEISGARBER RD SUITE 200 Knoxville, TN 37909 |
| Phone Number: | 8655848588 |
| Fax Number: | 8655843364 |
Provider Taxonomy:
| Primary: | 363L00000X |
| Secondary (if any): | 363LF0000X |
| State: | TN |
