Provider Demographics
NPI:1942514757
Name:ANDREWS, EMILY ODLUM (LAC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:ODLUM
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:AUSTIN
Other - Last Name:ODLUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:415 HARVEY AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-1913
Mailing Address - Country:US
Mailing Address - Phone:724-205-6377
Mailing Address - Fax:
Practice Address - Street 1:415 HARVEY AVE
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-1913
Practice Address - Country:US
Practice Address - Phone:724-205-6377
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-04
Last Update Date:2014-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT091.0065814171100000X
PAAK001044171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist