Provider First Line Business Practice Location Address:
4211 WAIALAE AVENUE
Provider Second Line Business Practice Location Address:
STE 405
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-5317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-735-1733
Provider Business Practice Location Address Fax Number:
808-735-1735
Provider Enumeration Date:
01/09/2006