Provider First Line Business Practice Location Address:
94-229 WAIPAHU DEPOT ST STE 302
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-3033
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-676-0785
Provider Business Practice Location Address Fax Number:
808-630-2463
Provider Enumeration Date:
12/07/2006