Provider First Line Business Practice Location Address:
590 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
SUITE 26
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-748-4080
Provider Business Practice Location Address Fax Number:
808-748-4791
Provider Enumeration Date:
05/20/2006