Provider First Line Business Practice Location Address:
1010 S KING ST
Provider Second Line Business Practice Location Address:
MEDICAL ARTS BLDG. #504
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-1701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-596-2553
Provider Business Practice Location Address Fax Number:
808-596-2554
Provider Enumeration Date:
09/02/2006