Provider First Line Business Practice Location Address:
3422 UPPER 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:
96815-4337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-651-6278
Provider Business Practice Location Address Fax Number:
808-356-0634
Provider Enumeration Date:
07/28/2014