Provider First Line Business Practice Location Address:
1 JARRETT WHITE ROAD
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHOLOGY MCHK-PH
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96822
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-433-5865
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/02/2005