Provider First Line Business Practice Location Address:
670 PROSPECT ST
Provider Second Line Business Practice Location Address:
504
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-1936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-521-4470
Provider Business Practice Location Address Fax Number:
808-521-5499
Provider Enumeration Date:
08/05/2010