Provider First Line Business Practice Location Address:
98-1079 MOANALUA ROAD
Provider Second Line Business Practice Location Address:
SUITE 420
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-488-7770
Provider Business Practice Location Address Fax Number:
808-487-0104
Provider Enumeration Date:
08/10/2006