Provider First Line Business Practice Location Address:
3747A WAIALAE AVE
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
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-892-3446
Provider Business Practice Location Address Fax Number:
808-379-3826
Provider Enumeration Date:
02/01/2021