Provider First Line Business Practice Location Address:
1329 LUSITANA ST
Provider Second Line Business Practice Location Address:
SUITE 710
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-450-2290
Provider Business Practice Location Address Fax Number:
808-545-2262
Provider Enumeration Date:
01/17/2009