Provider First Line Business Practice Location Address:
1360 S BERETANIA ST
Provider Second Line Business Practice Location Address:
#215
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-1520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-532-3711
Provider Business Practice Location Address Fax Number:
808-532-3713
Provider Enumeration Date:
07/07/2006