Provider First Line Business Practice Location Address:
1029 KAPAHULU AVE
Provider Second Line Business Practice Location Address:
STE 401
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-1332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-831-3226
Provider Business Practice Location Address Fax Number:
410-677-0883
Provider Enumeration Date:
06/08/2009