Healthcare Provider Details

I. General information

NPI: 1770572455
Provider Name (Legal Business Name): KAREN LYNNE ODOM P.T., M.O.M.T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 12/09/2025
Certification Date: 12/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4777 ANDREW JACKSON PKWY STE 101A-B
HERMITAGE TN
37076-1323
US

IV. Provider business mailing address

PO BOX 40525
NASHVILLE TN
37204-0525
US

V. Phone/Fax

Practice location:
  • Phone: 615-292-0199
  • Fax: 615-292-0357
Mailing address:
  • Phone: 615-292-2209
  • Fax: 615-292-0357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT0000003363
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: