Provider First Line Business Practice Location Address:
1301 PUNCHBOWL ST # 5
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:
96813-2499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-691-7152
Provider Business Practice Location Address Fax Number:
808-691-4001
Provider Enumeration Date:
04/29/2010