| NPI | 1700428901 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY E ODOM Owner 817-723-4441 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
| 111N00000X Chiropractor | |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2020-02-27 |