Provider First Line Business Practice Location Address:
3375 KOAPAKA ST
Provider Second Line Business Practice Location Address:
D108
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-1800
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-831-5882
Provider Business Practice Location Address Fax Number:
808-831-5888
Provider Enumeration Date:
01/29/2007