Provider First Line Business Practice Location Address:
3627 KILAUEA AVE RM 101
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:
96816-2317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-733-7997
Provider Business Practice Location Address Fax Number:
808-733-9357
Provider Enumeration Date:
01/23/2015