LISA NICOLE ODOM

COEUR D ALENE, ID
NPI1598007668
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy208000000X Pediatrics
(Licence: ID  M-13382)
Enumeration Date2013-03-26
Last Update Date2021-08-25
Business Address
Mrs. LISA NICOLE ODOM
1090 W PARK PL
COEUR D ALENE, ID 83814-2785
Phone number: 208-215-2005
Mailing Address
Mrs. LISA NICOLE ODOM
PO BOX 1387
HAYDEN, ID 83835-1387
Phone number: 208-415-0299
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