Provider First Line Business Practice Location Address:
1380 LUSITANA ST
Provider Second Line Business Practice Location Address:
SUITE 801
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2421
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-523-1658
Provider Business Practice Location Address Fax Number:
808-533-1201
Provider Enumeration Date:
07/31/2006