Provider First Line Business Practice Location Address:
1465 S KING ST APT 1
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:
96814-2510
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-255-4831
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/21/2005