Provider First Line Business Practice Location Address:
930 12TH 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:
96816-2251
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-737-9296
Provider Business Practice Location Address Fax Number:
808-737-9306
Provider Enumeration Date:
05/11/2012