Provider First Line Business Practice Location Address:
1329 LUSITANA STREET
Provider Second Line Business Practice Location Address:
SUITE 507
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2412
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-532-0155
Provider Business Practice Location Address Fax Number:
808-532-0160
Provider Enumeration Date:
06/10/2011