Provider First Line Business Practice Location Address:
320 WARD AVE
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-591-8778
Provider Business Practice Location Address Fax Number:
808-597-8282
Provider Enumeration Date:
01/31/2007