Provider First Line Business Practice Location Address:
1001 KAMOKILA BLVD.,
Provider Second Line Business Practice Location Address:
STE 114
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:
808-674-9595
Provider Business Practice Location Address Fax Number:
808-674-9696
Provider Enumeration Date:
06/12/2006