Provider First Line Business Practice Location Address:
3427 WAIALAE AVE
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-2619
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-737-5433
Provider Business Practice Location Address Fax Number:
808-737-4324
Provider Enumeration Date:
09/25/2006