Provider First Line Business Practice Location Address:
6163 SUMMER 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:
96821-2342
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-396-0537
Provider Business Practice Location Address Fax Number:
808-396-5128
Provider Enumeration Date:
01/25/2007