Provider First Line Business Practice Location Address:
2228 LILIHA STREET
Provider Second Line Business Practice Location Address:
MOD 105
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-538-1929
Provider Business Practice Location Address Fax Number:
808-538-1920
Provider Enumeration Date:
05/03/2007