Provider First Line Business Practice Location Address:
1907 S BERETANIA ST
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96826-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-952-9779
Provider Business Practice Location Address Fax Number:
808-952-9988
Provider Enumeration Date:
03/09/2007