Provider First Line Business Practice Location Address:
BUILDING 677
Provider Second Line Business Practice Location Address:
2-27 INF 3RD BDE 25 ID
Provider Business Practice Location Address City Name:
SCHOFIELD BARRACKS
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96786
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-433-8212
Provider Business Practice Location Address Fax Number:
808-433-8269
Provider Enumeration Date:
07/16/2010