Provider First Line Business Practice Location Address:
945 11TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-2240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-737-8812
Provider Business Practice Location Address Fax Number:
808-737-8812
Provider Enumeration Date:
11/17/2010