Provider First Line Business Practice Location Address:
94-408 AKOKI ST
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-2733
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-678-3668
Provider Business Practice Location Address Fax Number:
808-678-3669
Provider Enumeration Date:
08/22/2009