Provider First Line Business Practice Location Address:
122 HOAHANA PL
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:
96825-3520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-258-2598
Provider Business Practice Location Address Fax Number:
808-394-0948
Provider Enumeration Date:
01/24/2007