Provider First Line Business Practice Location Address:
1001 KAMOKILA BOULEVARD
Provider Second Line Business Practice Location Address:
JC BUILDING 102
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-674-9299
Provider Business Practice Location Address Fax Number:
808-674-9280
Provider Enumeration Date:
08/05/2006