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1508830308
WALLACE PAUL ODOM
HUNTSVILLE, AL
NPI
1508830308
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
367500000X Nurse Anesthetist, Certified Registered
(Licence: AL 1-071049)
Enumeration Date
2006-02-16
Last Update Date
2008-12-04
Business Address
Mr. WALLACE PAUL ODOM CRNA
911 BIG COVE RD SE
HUNTSVILLE, AL 35801-3750
Phone number: 256-265-8120
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Mailing Address
Mr. WALLACE PAUL ODOM CRNA
PO BOX 1389
HUNTSVILLE, AL 35807-0389
Phone number: 205-979-5882
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