Provider First Line Business Practice Location Address:
1268 YOUNG STREET
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-1801
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-593-8861
Provider Business Practice Location Address Fax Number:
808-593-8862
Provider Enumeration Date:
02/06/2007