Provider First Line Business Practice Location Address:
266 LUNALILO HOME RD
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96825-1807
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-395-1922
Provider Business Practice Location Address Fax Number:
808-395-1922
Provider Enumeration Date:
09/20/2008