Provider First Line Business Practice Location Address:
1580 MAKALOA ST
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:
96814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-979-7045
Provider Business Practice Location Address Fax Number:
808-973-1399
Provider Enumeration Date:
02/12/2013