Provider First Line Business Practice Location Address:
321 N KUAKINI ST
Provider Second Line Business Practice Location Address:
PACIFIC SPORTS REHAB, LLC SUITE 801
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-2364
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-521-2002
Provider Business Practice Location Address Fax Number:
888-417-2122
Provider Enumeration Date:
12/18/2006