Provider First Line Business Practice Location Address:
50 S BERETANIA ST
Provider Second Line Business Practice Location Address:
SUITE C210 A1
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-521-1165
Provider Business Practice Location Address Fax Number:
180-852-1185
Provider Enumeration Date:
11/11/2006