Provider First Line Business Practice Location Address:
3045 MONSARRAT AVE #7
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:
96815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-735-8883
Provider Business Practice Location Address Fax Number:
808-732-0240
Provider Enumeration Date:
10/02/2006