Provider First Line Business Practice Location Address:
4747 KILAUEA AVE
Provider Second Line Business Practice Location Address:
115
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:
808-255-3592
Provider Business Practice Location Address Fax Number:
808-735-3503
Provider Enumeration Date:
04/25/2007