Provider First Line Business Practice Location Address:
1001 KAMOKILA BLVD STE 249
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2091
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-695-7740
Provider Business Practice Location Address Fax Number:
808-695-7799
Provider Enumeration Date:
01/31/2007