Provider First Line Business Practice Location Address:
98 1079 MOANALUA RD
Provider Second Line Business Practice Location Address:
MOB SUITE 150
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-840-5660
Provider Business Practice Location Address Fax Number:
808-485-1700
Provider Enumeration Date:
02/09/2006