Cole Shane Odom
Cole Shane Odom is a Private Vehicle in Nampa, Idaho. Practices as a sole proprietor. Registered with an NPI since 2025.
- In the registry since
- 2025
- Specialties on file
- 2
Practice location Address checks out
3420 S Fork AveNampa, ID 83686
Phone: (208) 250-7733
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Intellectual and/or Developmental Disabilities Residential Treatment Facility (primary) | Taxonomy 320600000X |
|---|---|
| Private Vehicle | Taxonomy 347C00000X |
Record details
| NPI number | 1821971326 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | July 30, 2025 |
| Last updated in NPPES | July 30, 2025 |
| Certification date | July 30, 2025 |
| Mailing address | 3420 S Fork Ave, Nampa, ID 83686-4856 |
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Mrs. Patricia L. Gammett
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