NPI 1821971326
Cole Shane Odom
Practice location
- Address
- 3420 S. Fork Ave, Nampa, ID 83686
- Phone
- (208) 250-7733
- Mailing address
- 3420 S Fork Ave, Nampa, ID 83686-4856
Registered specialties (2)
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Private Vehicle
Registry record
- NPI
- 1821971326
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 30 Jul 2025
- Record last updated
- 30 Jul 2025
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.