Provider First Line Business Practice Location Address:
50 S BERETANIA ST STE C211C
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
88-532-2020
Provider Business Practice Location Address Fax Number:
88-532-2027
Provider Enumeration Date:
07/06/2017