RUSS ODOM CMT, CMMP
NPI 1104172253
Massage Therapist in San Diego, CA
About Russ Odom Cmt, Cmmp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
RUSS ODOM CMT, CMMP (NPI 1104172253) is an individual massage therapist in San Diego, California, licensed in California (30211) and active in the NPI registry since July 2012.
NPPES Registry Identity
Specialties & Licenses
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Russ Odom's NPI number?
The NPI number for Russ Odom is 1104172253. It was assigned to this individual provider in the NPPES registry on July 26, 2012.
Where is Russ Odom located?
Russ Odom practices at 2128 Crenshaw St, San Diego, CA 92105. The listed phone number is (619) 339-1306.
What is Russ Odom's specialty?
The primary specialty registered for this NPI is Massage Therapist with taxonomy code 225700000X.
When was this NPI record last updated?
The NPPES record for Russ Odom was last updated on July 26, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Russ Odom, CMT, CMMP · NPI 1104172253
Massage Therapist provider in San Diego, California. Individual provider, active in the CMS NPPES registry since July 26, 2012.
## Identity
- **NPI:** 1104172253 (Entity type: Individual)
- **Enumerated:** July 26, 2012
- **Primary specialty:** Massage Therapist · taxonomy 225700000X
- **State license:** 30211 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 2128 CRENSHAW ST, San Diego, CA 92105-5130
- **Phone:** (619) 339-1306
## Record status
- **NPPES last updated:** July 26, 2012
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Source: [NPI Profile](https://npiprofile.com/npi/1104172253) · Data from the CMS NPPES public registry.