Provider First Line Business Practice Location Address:
2055 N KING ST
Provider Second Line Business Practice Location Address:
SUITE 205B
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-3479
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-460-3443
Provider Business Practice Location Address Fax Number:
877-444-4662
Provider Enumeration Date:
12/30/2008