Provider First Line Business Practice Location Address:
400 SAND ISLAND PKWY
Provider Second Line Business Practice Location Address:
CGC KUKUI (WLB-203)
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-4326
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-842-2860
Provider Business Practice Location Address Fax Number:
808-842-2864
Provider Enumeration Date:
02/06/2007