Provider First Line Business Practice Location Address:
275 PUUHALE RD
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-2237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-851-7030
Provider Business Practice Location Address Fax Number:
808-851-7031
Provider Enumeration Date:
01/03/2007