Provider First Line Business Practice Location Address:
98-1247 KAAHUMANU ST
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-5300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-487-5500
Provider Business Practice Location Address Fax Number:
808-486-2694
Provider Enumeration Date:
01/10/2006