Provider First Line Business Practice Location Address:
1531 BERTRAM ST
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:
96816-1926
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-772-1191
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/11/2023