National Provider Identifier

Larry Odom

Larry Odom is listed in the NPPES registry with a primary specialty of Licensed Practical Nurse in Williamsville, NY and a listed phone number of (716) 400-9339.

NPI 1205258225Williamsville, NYLicensed Practical Nurse

Profile Overview

NPI
1205258225
Provider Type
Individual
Primary Specialty
Licensed Practical Nurse
Enumeration Date
January 09, 2014
Last Updated
January 09, 2014

Practice Location

  • 238 Teakwood Ter
  • Williamsville, NY 14221-4737

Phone: (716) 400-9339

Specialties

  • Licensed Practical Nurse (164W00000X)
Full Record
NPI
1205258225
Entity Type
Individual
Last Name
Odom
First Name
Larry
Name Prefix
Mr.
Mailing Street Address
238 Teakwood Ter
Mailing City
Williamsville
Mailing State
NY
Mailing ZIP Code
14221-4737
Mailing Country
US
Mailing Phone
(716) 400-9339
Practice Street Address
238 Teakwood Ter
Practice City
Williamsville
Practice State
NY
Practice ZIP Code
14221-4737
Practice Country
US
Practice Phone
(716) 400-9339
Enumeration Date
January 09, 2014
Last Updated
January 09, 2014
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Licensed Practical Nurse (164W00000X)