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Individual

MRS. ANNIE LUM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
735 RIDGE RD, CANTON, GA 30114-4170
(631) 885-5510
Mailing address
735 RIDGE RD, CANTON, GA 30114-4170
(631) 885-5510

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN235987
GA

Other

Enumeration date
07/05/2012
Last updated
01/28/2023
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