Provider First Line Business Practice Location Address:
619 KAPAHULU AVE., STE 209
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:
96816-1495
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-228-6142
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/17/2012