Provider First Line Business Practice Location Address:
4211 WAIALAE AVE
Provider Second Line Business Practice Location Address:
SUITE 108
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-5319
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-737-5811
Provider Business Practice Location Address Fax Number:
808-737-7971
Provider Enumeration Date:
02/22/2007