Provider First Line Business Practice Location Address:
1029 KAPAHULU AVE
Provider Second Line Business Practice Location Address:
STE 500
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-1332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-591-1504
Provider Business Practice Location Address Fax Number:
808-591-1506
Provider Enumeration Date:
04/07/2010