Provider First Line Business Practice Location Address:
1380 LUSITANA ST STE 905
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:
96813-2448
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-522-9633
Provider Business Practice Location Address Fax Number:
808-522-9646
Provider Enumeration Date:
02/29/2012