Provider First Line Business Practice Location Address:
848 S BERETANIA ST
Provider Second Line Business Practice Location Address:
SUITE 311
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-227-2136
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2015