Provider First Line Business Practice Location Address:
1268 YOUNG ST
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-1801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-384-3840
Provider Business Practice Location Address Fax Number:
888-352-6787
Provider Enumeration Date:
09/15/2006