Provider First Line Business Practice Location Address:
3221 WAIALAE AVE STE 345
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:
96816-5800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-732-5223
Provider Business Practice Location Address Fax Number:
808-735-9598
Provider Enumeration Date:
06/24/2020