Provider First Line Business Practice Location Address:
1425 LILIHA ST
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96817-3522
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-523-1343
Provider Business Practice Location Address Fax Number:
808-523-1345
Provider Enumeration Date:
09/26/2006