Provider First Line Business Practice Location Address:
4211 WAIALAE AVE STE 401
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:
96816-5317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-732-1221
Provider Business Practice Location Address Fax Number:
808-734-3928
Provider Enumeration Date:
11/16/2006