Provider First Line Business Practice Location Address:
250 MAKALAPA DR
Provider Second Line Business Practice Location Address:
COMPACFLT HEALTH SVC (N01HD) ATTN: PROF AFFAIRS COORD
Provider Business Practice Location Address City Name:
PEARL HARBOR
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96860-3131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-471-2463
Provider Business Practice Location Address Fax Number:
808-474-7806
Provider Enumeration Date:
12/16/2005