Provider First Line Business Practice Location Address:
1907 S BERETANIA 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:
96826-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-949-3444
Provider Business Practice Location Address Fax Number:
808-949-7808
Provider Enumeration Date:
03/21/2011