Provider First Line Business Practice Location Address:
94-307 FARRINGTON HWY., SUITE A-09
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-2500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-294-3189
Provider Business Practice Location Address Fax Number:
808-888-6058
Provider Enumeration Date:
12/15/2020