Provider First Line Business Practice Location Address:
846 S HOTEL ST
Provider Second Line Business Practice Location Address:
STE 102
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2583
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-536-2031
Provider Business Practice Location Address Fax Number:
808-536-2033
Provider Enumeration Date:
01/02/2009