Provider First Line Business Practice Location Address:
1712 LILIHA ST
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-5410
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-545-5478
Provider Business Practice Location Address Fax Number:
808-536-4810
Provider Enumeration Date:
10/23/2015