Provider First Line Business Practice Location Address:
100 N BERETANIA ST
Provider Second Line Business Practice Location Address:
SUITE 203B
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-4712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-521-2288
Provider Business Practice Location Address Fax Number:
808-521-2271
Provider Enumeration Date:
01/19/2007