Provider First Line Business Practice Location Address:
98-489 LUMIAINA ST
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-294-7050
Provider Business Practice Location Address Fax Number:
619-374-7134
Provider Enumeration Date:
10/16/2008