Provider First Line Business Practice Location Address:
86-107 HOAHA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WAIANAE
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96792-3021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-368-2231
Provider Business Practice Location Address Fax Number:
808-696-2430
Provider Enumeration Date:
02/04/2014