NPI 1679069025
Matthew Odishoo
Practice location
- Address
- 2114 S 118th Ave, Avondale, AZ 85323-7643
- Phone
- (623) 792-7930
- Fax
- (623) 777-1683
Registered specialties
Adult Companion
Primary
Registry record
- NPI
- 1679069025
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 9 Jul 2018
- Record last updated
- 9 Jul 2018
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.