Provider First Line Business Practice Location Address:
4747 KILAUEA AVE
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:
96816-5308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-778-8443
Provider Business Practice Location Address Fax Number:
808-737-7355
Provider Enumeration Date:
07/18/2007