Provider First Line Business Practice Location Address:
683 WAIANAE AVE BLDG 677
Provider Second Line Business Practice Location Address:
DDHC 3RD BRIGADE SCMH
Provider Business Practice Location Address City Name:
SCHOFIELD BARRACKS
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96786-6000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-433-8255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/16/2018