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1962081810
CRYSTAL NOEL ODEGARD
EAGLE, ID
NPI
1962081810
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: ID PA-1982)
Enumeration Date
2021-04-07
Last Update Date
2021-04-07
Business Address
Mrs. CRYSTAL NOEL ODEGARD PA-C
1079 S ANCONA AVE STE 100
EAGLE, ID 83616-7443
Phone number: 208-853-2273
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Mailing Address
Mrs. CRYSTAL NOEL ODEGARD PA-C
1652 W SUNNY SLOPE DR
MERIDIAN, ID 83642-4336
Phone number: 541-285-4851
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