Provider First Line Business Practice Location Address:
501 SUMNER ST
Provider Second Line Business Practice Location Address:
UNIT 602
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-5332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-538-3448
Provider Business Practice Location Address Fax Number:
808-538-3752
Provider Enumeration Date:
04/29/2011