Provider First Line Business Practice Location Address:
98-151 PALI MOMI ST
Provider Second Line Business Practice Location Address:
SUITE 142
Provider Business Practice Location Address City Name:
AIEA
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96701-4300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-483-6400
Provider Business Practice Location Address Fax Number:
808-483-6489
Provider Enumeration Date:
10/19/2006