Provider First Line Business Practice Location Address:
839 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:
96813-2501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-522-4441
Provider Business Practice Location Address Fax Number:
808-522-2483
Provider Enumeration Date:
11/17/2006