Provider First Line Business Practice Location Address:
601 KAMOKILA BLVD
Provider Second Line Business Practice Location Address:
ROOM 355-OAHU LEEWARD FGC
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-692-7700
Provider Business Practice Location Address Fax Number:
808-692-7712
Provider Enumeration Date:
11/18/2011