Provider First Line Business Practice Location Address:
1149 BETHEL ST
Provider Second Line Business Practice Location Address:
#509
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96813-2236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-953-2121
Provider Business Practice Location Address Fax Number:
808-524-6618
Provider Enumeration Date:
10/11/2009