Provider First Line Business Practice Location Address:
1374 NUUANU AVE
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:
96817-4032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-691-4908
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2015