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Organization
ELAM SPORTS, INC
Active
Organization
ELAM SPORTS, INC
Active
Other names
Elam Sports O'ahu, Elam Sports Oahu
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA L ELAM (COMPANY OFFICER)
(808) 382-1372
Entity
Organization
Contact information
Practice address
91-1027 SHANGRILA ST BLDG 1867, KAPOLEI, HI 96707-2101
(808) 674-9595
(808) 674-9696
Mailing address
PO BOX 701119, KAPOLEI, HI 96709-1119
(808) 674-9595
(808) 674-9696
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
NULL
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A0218931
HMSA
HI
05
—
50320201
—
HI
Enumeration date
06/19/2006
Last updated
08/11/2022
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