Provider First Line Business Practice Location Address:
550 S BERETANIA ST
Provider Second Line Business Practice Location Address:
PHYSICIAN OFFICE BLDG 3, SUITE 703
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-691-4449
Provider Business Practice Location Address Fax Number:
808-691-4015
Provider Enumeration Date:
01/08/2007