Provider First Line Business Practice Location Address:
1144 KOKO HEAD AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96816-3799
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-382-3226
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2012