Provider First Line Business Practice Location Address:
4380 LAWEHANA ST STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96818-3129
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-423-6828
Provider Business Practice Location Address Fax Number:
808-422-6049
Provider Enumeration Date:
09/01/2016