Provider First Line Business Practice Location Address:
1060 YOUNG ST
Provider Second Line Business Practice Location Address:
SUITE 212
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814-1609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-538-0047
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/22/2007