Provider First Line Business Practice Location Address:
338 KAMOKILA BLVD STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
KAPOLEI
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96707-2055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-674-2255
Provider Business Practice Location Address Fax Number:
808-674-1771
Provider Enumeration Date:
02/12/2007