Provider First Line Business Practice Location Address:
85-876 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
WAIANAE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96792-2498
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-696-4049
Provider Business Practice Location Address Fax Number:
808-696-4188
Provider Enumeration Date:
01/02/2007