Provider First Line Business Practice Location Address:
210 WARD AVE
Provider Second Line Business Practice Location Address:
SUITE 219
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-4008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-585-1424
Provider Business Practice Location Address Fax Number:
808-585-0379
Provider Enumeration Date:
03/08/2017