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Organization
ELAM SPORTS, INC.
Active
Organization
ELAM SPORTS, INC.
Active
Other names
Elam Sports Oahu
Organization subpart
No
Provider details
NPI number
Authorized official
CHANDRA L ELAM (COMPANY OFFICER)
(808) 674-9595
Entity
Organization
Contact information
Practice address
425 KAMEHAMEHA HWY, SUITE 2B, PEARL CITY, HI 96782-3238
(808) 674-9595
(808) 674-9696
Mailing address
1001 KAMOKILA BLVD, SUITE 111 JCB, KAPOLEI, HI 96707-2014
(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
05
—
50320201
—
HI
01
—
A218931
HMSA
HI
Enumeration date
06/30/2006
Last updated
11/27/2007
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