Individual provider · Type 1 NPI

Russ Odom, CMT, CMMP

Massage Therapist · San Diego, CA

NPI number 1104172253 Active

Practice location

2128 Crenshaw St
San Diego, CA 92105-5130

Call (619) 339-1306 Map

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000X30211 (CA)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1104172253

Russ Odom, CMT, CMMP's National Provider Identifier is 1104172253, issued on Jul 26, 2012. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in San Diego, CA. The record was last updated on Jul 26, 2012.