Provider First Line Business Practice Location Address:
108 OLOKANI PL
Provider Second Line Business Practice Location Address:
2ND FL
Provider Business Practice Location Address City Name:
WAHIAWA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96786-4812
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-621-2670
Provider Business Practice Location Address Fax Number:
808-621-0639
Provider Enumeration Date:
12/06/2009