Provider First Line Business Practice Location Address:
1130 N NIMITZ HWY RM A153
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:
96817-5777
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-536-8686
Provider Business Practice Location Address Fax Number:
877-712-3920
Provider Enumeration Date:
07/23/2014