Provider First Line Business Practice Location Address:
1500 SO BERETANIA ST
Provider Second Line Business Practice Location Address:
SUITE 403
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-945-3690
Provider Business Practice Location Address Fax Number:
808-945-2811
Provider Enumeration Date:
07/24/2008