Provider First Line Business Practice Location Address:
1500 S BERETANIA ST
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96826-1932
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-946-4814
Provider Business Practice Location Address Fax Number:
808-947-5978
Provider Enumeration Date:
02/09/2007