Provider First Line Business Practice Location Address:
60 N BERETANIA STREET
Provider Second Line Business Practice Location Address:
2402
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-4760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-215-9174
Provider Business Practice Location Address Fax Number:
808-465-3261
Provider Enumeration Date:
01/31/2007