Provider First Line Business Practice Location Address:
459 PATTERSON RD
Provider Second Line Business Practice Location Address:
VA PIHCS
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-1522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-433-0618
Provider Business Practice Location Address Fax Number:
808-433-0392
Provider Enumeration Date:
05/11/2006