Provider First Line Business Practice Location Address:
1380 LUSITANA ST
Provider Second Line Business Practice Location Address:
SUITE 808
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2449
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-538-1050
Provider Business Practice Location Address Fax Number:
808-538-0108
Provider Enumeration Date:
04/18/2013