Provider First Line Business Practice Location Address:
1236 WAIMANU ST STE A
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:
96814-4305
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-352-6144
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/29/2019