Provider First Line Business Practice Location Address:
98-1247 KAAHUMANU ST STE 118A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-5310
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-488-4342
Provider Business Practice Location Address Fax Number:
808-488-4151
Provider Enumeration Date:
12/19/2006