Provider First Line Business Practice Location Address:
1121 MIDDLE ST
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:
96819-2402
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-286-8124
Provider Business Practice Location Address Fax Number:
808-832-3043
Provider Enumeration Date:
06/12/2008