Provider First Line Business Practice Location Address:
1250 PUNCHBOWL ST
Provider Second Line Business Practice Location Address:
ROOM 210
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2416
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-586-4618
Provider Business Practice Location Address Fax Number:
808-586-8165
Provider Enumeration Date:
05/05/2009