Provider First Line Business Practice Location Address:
3849 OLD PALI RD
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:
96817-1070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-780-4536
Provider Business Practice Location Address Fax Number:
808-595-4505
Provider Enumeration Date:
08/19/2006