Provider First Line Business Practice Location Address:
2953 KALIHI ST
Provider Second Line Business Practice Location Address:
APT. A
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-6001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-778-7055
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/05/2011