Provider First Line Business Practice Location Address:
1301 PUNCHBOWL 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:
96813-2499
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-691-7143
Provider Business Practice Location Address Fax Number:
808-691-7496
Provider Enumeration Date:
10/18/2007