Provider First Line Business Practice Location Address:
579 FARRINGTON HWY STE 101
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-674-2273
Provider Business Practice Location Address Fax Number:
808-674-2552
Provider Enumeration Date:
09/25/2007