Individual
JUSTIN LUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
12326 E 86TH ST N, OWASSO, OK 74055
(918) 272-3750
Mailing address
4812 E 33RD ST, TULSA, OK 74135-2038
(918) 622-4126
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4972
OK
Other
Enumeration date
04/17/2015
Last updated
09/20/2018
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