Provider First Line Business Practice Location Address:
1380 LUSITANA ST STE 707
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:
96813-2443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-545-3538
Provider Business Practice Location Address Fax Number:
808-545-3532
Provider Enumeration Date:
09/29/2006