Provider First Line Business Practice Location Address:
928 NUUANU AVE STE LL2
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:
96817-5190
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-664-1104
Provider Business Practice Location Address Fax Number:
866-592-3149
Provider Enumeration Date:
05/17/2006