Odom Sports Medicine, P.a.

NPI 1275557886 - Family Medicine - 207QS0010X

NPI Details
NPI 1275557886
Enumeration Date 07/27/2006
Last Updated 05/02/2013
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name JOHN H JOHN
Position PRESIDENT
Phone (952) 545-2225
Fax
Practice Location
10500 WAYZATA BLVD
MINNETONKA MN, 55305-1511, US
Phone (952) 545-2225
Fax
Business Location
10500 WAYZATA BLVD
MINNETONKA MN, 55305-1511, US
Phone (952) 224-1919
Fax
Toxanomy
Taxonomy Code 207QS0010X
License State
License Number
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According to our database, Odom Sports Medicine, P.a. NPI is 1275557886, taxonomy code is 207QS0010X Odom Sports Medicine, P.a. physically located at 10500 Wayzata Blvd, Minnetonka MN, 55305-1511. NPI Number 1033115704 has the healthcare provider type.

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1275557886 NPI number is provided on an as is basis without warranty of any kind. 1275557886 is maintained by the National Plan & Provider Enumeration System. The contents of Odom Sports Medicine, P.a. are for informational purposes only.