Individual
BRIAN RAY LUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
45211 HELM ST, PLYMOUTH, MI 48170-6023
(800) 741-5985
Mailing address
2174 PALMS RD, COLUMBUS, MI 48063-3904
(248) 259-7407
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
3873
MI
Other
Enumeration date
06/09/2021
Last updated
06/09/2021
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