Provider First Line Business Practice Location Address:
1380 LUSITANA ST STE 512
Provider Second Line Business Practice Location Address:
PHYSICIAN'S OFFICE BUILDING
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2441
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-748-4488
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/21/2007