Provider First Line Business Practice Location Address:
1380 LUSITANA ST #1007
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-521-2992
Provider Business Practice Location Address Fax Number:
808-521-2522
Provider Enumeration Date:
05/16/2008