Provider First Line Business Practice Location Address:
3989 DIAMOND HEAD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-4413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-737-7995
Provider Business Practice Location Address Fax Number:
808-735-9756
Provider Enumeration Date:
06/14/2007