Provider First Line Business Practice Location Address:
210 WARD AVENUE
Provider Second Line Business Practice Location Address:
SUITE 219B
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-380-4465
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/17/2014