Individual
ETHAN LUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
A.T.C
Contact information
Practice address
3142 WAIALAE AVE, HONOLULU, HI 96816-1510
(808) 739-4824
Mailing address
98-149 PUAALII ST, AIEA, HI 96701-2205
(808) 780-1564
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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