Provider First Line Business Practice Location Address:
1144 10TH AVE
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-2442
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-732-2355
Provider Business Practice Location Address Fax Number:
808-828-0704
Provider Enumeration Date:
08/22/2006