Provider First Line Business Practice Location Address:
1020 S BERETANIA ST
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:
96814-1428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-545-2740
Provider Business Practice Location Address Fax Number:
808-545-2852
Provider Enumeration Date:
06/04/2006