Provider First Line Business Practice Location Address:
94-300 FARRINGTON HWY
Provider Second Line Business Practice Location Address:
#F-8
Provider Business Practice Location Address City Name:
WAIPAHU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96797-2648
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-677-1433
Provider Business Practice Location Address Fax Number:
808-677-1676
Provider Enumeration Date:
09/20/2006