Provider First Line Business Practice Location Address:
94-1221 KA UKA BLVD, UNIT 108
Provider Second Line Business Practice Location Address:
#167
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-292-7968
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/26/2017