Provider First Line Business Practice Location Address:
480 CENTRAL AVE
Provider Second Line Business Practice Location Address:
ATTN MEDICAL STAFF SERVICES PROF- RM218
Provider Business Practice Location Address City Name:
J B P H H
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96860-4908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-471-1866
Provider Business Practice Location Address Fax Number:
808-471-0918
Provider Enumeration Date:
03/11/2011