Provider First Line Business Practice Location Address:
4211 WAIALAE AVE STE 201
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:
96816-5312
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-737-0076
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/14/2007