Provider First Line Business Practice Location Address:
1029 KAPAHULU AVE 502
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:
96816-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-782-1861
Provider Business Practice Location Address Fax Number:
808-218-7830
Provider Enumeration Date:
07/16/2008