Provider First Line Business Practice Location Address:
1712 LILIHA ST
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-5409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-545-8361
Provider Business Practice Location Address Fax Number:
808-545-2362
Provider Enumeration Date:
12/11/2006