Provider First Line Business Practice Location Address:
3554 LIKINI ST
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:
96818-2105
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-255-6469
Provider Business Practice Location Address Fax Number:
808-260-1723
Provider Enumeration Date:
11/28/2025