Provider First Line Business Practice Location Address:
3221 WAIALAE AVE STE 360
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:
96816-5849
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-744-2543
Provider Business Practice Location Address Fax Number:
808-748-0980
Provider Enumeration Date:
09/06/2014