Provider First Line Business Practice Location Address:
98-1277 KAAHUMANU ST
Provider Second Line Business Practice Location Address:
PMB-355
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-5314
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-945-0333
Provider Business Practice Location Address Fax Number:
808-455-6671
Provider Enumeration Date:
06/25/2010