Provider First Line Business Practice Location Address:
1401 S BERETANIA ST
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:
96814-1870
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-585-8855
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/30/2022