Provider First Line Business Practice Location Address:
1215 CENTER ST STE 204
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:
96816-3209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-657-6213
Provider Business Practice Location Address Fax Number:
949-561-5371
Provider Enumeration Date:
03/22/2012