Provider First Line Business Practice Location Address:
1205 ALEXANDER ST
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:
96826-1229
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-946-5027
Provider Business Practice Location Address Fax Number:
866-596-0130
Provider Enumeration Date:
06/15/2005