Provider First Line Business Practice Location Address:
480 CENTRAL AVENUE
Provider Second Line Business Practice Location Address:
NAVAL HEALTH CLINIC HAWAII
Provider Business Practice Location Address City Name:
PEARL HARBOR
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96860
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
831-512-2662
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2010