Provider First Line Business Practice Location Address:
1040 S KING ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-2117
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-597-1322
Provider Business Practice Location Address Fax Number:
808-597-8932
Provider Enumeration Date:
06/18/2007