Provider First Line Business Practice Location Address:
3124 NUMANA RD
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:
96819-2908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-722-9175
Provider Business Practice Location Address Fax Number:
808-832-3538
Provider Enumeration Date:
01/22/2010