Provider First Line Business Practice Location Address:
1100 WARD AVE STE 701
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:
96814-1617
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-791-7844
Provider Business Practice Location Address Fax Number:
808-791-7844
Provider Enumeration Date:
10/16/2006