Provider First Line Business Practice Location Address:
KAPOLEI BUILDING
Provider Second Line Business Practice Location Address:
1001 KAMOKILA BLVD, SUITE 193
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2014
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-693-7300
Provider Business Practice Location Address Fax Number:
808-693-7301
Provider Enumeration Date:
03/29/2007