Wade in the Water Medicine LLC

NPI #1629416730 in Chattanooga, Tennessee

Provider Information

NPI Number: 1629416730
Entity Type: Organization
Organization Name: Wade in the Water Medicine LLC
Primary Specialty: Specialist
Enumeration Date: Jun 11, 2013
Last Updated: Apr 30, 2014

Practice Location

Address: 5600 BRAINERD RD
Address 2: FC5
City: Chattanooga
State: Tennessee
ZIP Code: 37411-5310
Phone: (423) 355-5471

Authorized Official

Name: DR. CARROLL G ODEM, MD
Title: PRESIDENT
Phone: (423) 400-9910

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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