Provider First Line Business Practice Location Address:
98-211 PALI MOMI ST
Provider Second Line Business Practice Location Address:
SUITE 801
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-4301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-488-6631
Provider Business Practice Location Address Fax Number:
808-484-8193
Provider Enumeration Date:
02/28/2007