Provider First Line Business Practice Location Address:
200 N VINEYARD BLVD BLDG B
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:
96817-3938
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-543-8445
Provider Business Practice Location Address Fax Number:
808-735-4194
Provider Enumeration Date:
08/31/2009