Provider First Line Business Practice Location Address:
634 KALIHI ST
Provider Second Line Business Practice Location Address:
ROOM 204
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96819-4063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-848-0088
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/25/2006