Provider Demographics
NPI:1174813992
Name:ODMAN, BABARA JEAN (MASSAGE THERAPIST)
Entity type:Individual
Prefix:
First Name:BABARA
Middle Name:JEAN
Last Name:ODMAN
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:213 SIBLEY ST
Mailing Address - Street 2:#106
Mailing Address - City:HASTINGS
Mailing Address - State:MN
Mailing Address - Zip Code:55033-1252
Mailing Address - Country:US
Mailing Address - Phone:651-398-2869
Mailing Address - Fax:
Practice Address - Street 1:7424 E POINT DOUGLAS RD S
Practice Address - Street 2:
Practice Address - City:COTTAGE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55016-3025
Practice Address - Country:US
Practice Address - Phone:651-398-2869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-13
Last Update Date:2011-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist